Smith et al. demonstrate the viability of animal metacognition research. We commend their effort and suggest three avenues of research. The first concerns whether animals are explicitly aware of their metacognitive processes. The second asks whether animals have metaknowledge of their own uncertain responses. The third issue concerns the monitoring/control distinction. We suggest some ways in which these issues elucidate metacognitive processes in nonhuman animals.

Authorship of a scientific paper is important in recognition of one’s work, and in the academic setting, helps in professional promotion. Conflicting views of authorship have led to disputes and debates in many scientific communities. Addressing ethical issues in medical research and publishing, and conforming to the requirements of international organizations and local research ethics boards, has become an essential part of the research endeavor. Ethical issues of biomedical authorship have been a matter of debate for years. Authorship problems may (...) involve problems with integrity, including ghost authorship and guest authorship. Some scientific disciplines, such as engineering or social sciences, may not have a firm guideline for authorship criteria; however this article reviews the criteria of authorship recommended by related international organizations of biomedical field and discusses common scenarios that may lead to authorship disputes and misconducts as well as issues related to authorship in multicenter studies. The paper also discusses possible scenarios that might be legitimate to make changes in authorship lists. (shrink)

The most common solutions to the problem of high pharmaceutical prices have taken the form of regulations, price negotiations, or changes in drug coverage by insurers. These measures for the most part transfer the burden of drug expenditures between pharmaceutical companies and payers or between payers. The aim of this study is to propose an alternative model for the relationship between the main stakeholders involved in the price setting and purchasing of pharmaceuticals, one that encourages a more cooperative approach. We (...) draw from principles of ethics and health economics and apply them to the context of the pharmaceutical industry. The model prioritises two objectives, to make drugs financially accessible to the patients who need them, and to keep pharmaceutical companies viable and profitable. It is centered around the sharing of financial risk between the main stakeholders, which we describe as ‘enlightened risk sharing’. After establishing the foundations of this model, we expand on the type of policies that can follow these principles with current day examples. (shrink)

Humanitarian healthcare work presents a range of ethical challenges for expatriate healthcare professionals, including tragic choices requiring the selection of a least-worst option. In this paper we examine a particular set of tragic choices related to the prioritization of care and allocation of scarce resources between individuals in situations of widespread and urgent health needs. Drawing on qualitative interviews with clinicians, we examine the nature of these choices. We offer recommendations to clinical teams and aid organizations for preparing and supporting (...) frontline clinicians in their efforts to determine the least-worst option, and in their responsibility for making such choices. (shrink)

Managing non-communicable diseases in crisis-affected and fragile humanitarian contexts requires special attention because primary health care systems often collapse or become compromised in such settings. As a result, addressing and managing these diseases become more challenging. Humanitarian organizations that intervene in crisis situations are increasingly including NCD management in the services they support and provide; however, they encounter a range of issues such as ensuring the quality of care, sustainability of programs, and the possibility of unintended harms. This case study (...) explores ethical considerations raised by a mobile NCD program run by an international humanitarian organization in a country affected by a protracted civil war. (shrink)

The application of evidence-based medicine helps clinicians avoid unnecessary procedures and decreases unnecessary harm for future patients while sparing economic burdens. Randomised controlled trials most accurately produce best research evidence. In arthroscopic surgery, however, many procedures have been extensively used without supportive evidence verified with RCTs. In this paper, we introduce two procedures, where over 30 years of procedure usage has continued prior to garnering evidence for the inefficacy of the procedures. The situations are attributed to the fact that clinical (...) trials in arthroscopic surgeries are challenging given the use of placebo controls. A placebo-control RCT can accurately answer research questions about efficacy and safety of surgical procedures; however, the majority of arthroscopic surgeries in practice have not been rigorously tested against placebo surgeries. This is because preparing surgical placebo controls, known as sham surgeries, are ethically controversial. Also considering that high-quality study results often do not change clinical practice due to insufficient knowledge translation, the benefits of such trials may be uncertain to society at large. Additionally, there are a lack of clear guidelines for conducting arthroscopic placebo surgeries in RCTs. We hope that this article helps drive discussion about appropriate use of placebo surgeries in RCTs to produce the best quality evidence in arthroscopic surgery. (shrink)

Thinkers in related fields such as philosophy, psychology, and education define metacognition in a variety of different ways. Based on an emerging standard definition in psychology, we present evidence for metacognition in animals, and argue that mindreading and metacognition are largely orthogonal.

In this article, we present an ethics framework for health practice in humanitarian and development work: the ethics of engaged presence. The ethics of engaged presence framework aims to articulate in a systematic fashion approaches and orientations that support the engagement of expatriate health care professionals in ways that align with diverse obligations and responsibilities, and promote respectful and effective action and relationships. Drawn from a range of sources, the framework provides a vocabulary and narrative structure for examining the moral (...) dimensions of providing development or humanitarian health assistance to individuals and communities, and working with and alongside local and international actors. The elements also help minimize or avoid certain miscalculations and harms. Emphasis is placed on the shared humanity of those who provide and those who receive assistance, acknowledgement of limits and risks related to the contributions of expatriate health care professionals, and the importance of providing skillful and relevant assistance. These elements articulate a moral posture for expatriate health care professionals that contributes to orienting the practice of clinicians in ways that reflect respect, humility, and solidarity. Health care professionals whose understanding and actions are consistent with the ethics of engaged presence will be oriented toward introspection and reflective practice and toward developing, sustaining and promoting collaborative partnerships. (shrink)

Humanitarian healthcare work presents a range of ethical challenges for expatriate healthcare professionals, including tragic choices requiring the selection of a least-worst option. In this paper we examine a particular set of tragic choices related to the prioritization of care and allocation of scarce resources between individuals in situations of widespread and urgent health needs. Drawing on qualitative interviews with clinicians, we examine the nature of these choices. We offer recommendations to clinical teams and aid organizations for preparing and supporting (...) frontline clinicians in their efforts to determine the least-worst option, and in their responsibility for making such choices. (shrink)

This text includes practical coverage of all the issues likely to be of concern to students during their medical careers.

As rationing decisions become more of an immediate reality for healthcare practitioners it is important to design mechanisms that facilitate carefully deliberated outcomes. No individual can be expected to be able to cover wide debate on their own, so an exercise has been designed that helps generate consensus decisions from diverse opinions. The exercise was piloted with two groups, an undergraduate medical class and the members of a general practice. Though the aims were different for each group, the tool was (...) useful to both for producing the desired outcomes. Expert and non-expert knowledge were drawn upon and rationing prioritisation lists regarding funding of infertility treatment were generated. A description of the exercise and the results produced by the two groups are provided, as well as the theoretical placement for the significance of forming consensus from diversity. (shrink)

Health care providers (HCPs) are routinely placed into morally challenging situations that have the potential to cause moral distress. This is especially true for HCPs working in the military, whether they are on deployment outside their typical contexts of practice such as in disaster relief (e.g., Haiti and the Ebola missions in West Africa), or in more typically military settings such as peace keeping or armed conflicts (e.g., Afghanistan, Syria). Moral distress refers to “painful feelings and/or psychological disequilibrium” (Nilsson, Sjöberg, (...) Kallenberg, & Larsson, 2011, p. 50) that occur when an individual is aware of a morally appropriate action in a moral dilemma but obstruction prevents them from carrying it out, or when in a situation where they must choose between upholding equally treasured but conflicting moral values. Similarly, moral distress can occur when faced with a ‘tragic choice’ where all available courses of action require something of moral significance to be given up, such as surgical triage in a mass casualty event (Hunt, Sinding, & Schwartz, 2012). In the literature, moral distress has been connected to negative psychological effects and even stress related mental health issues including compassion fatigue, burnout, and post-traumatic stress disorder (Owen & Wanzer, 2014; Gustafsson, Eriksson, Strandberg, & Norberg, 2010; Litz, et al., 2009). (shrink)

In this article, we present an ethics framework for health practice in humanitarian and development work: the ethics of engaged presence. The ethics of engaged presence framework aims to articulate in a systematic fashion approaches and orientations that support the engagement of expatriate health care professionals in ways that align with diverse obligations and responsibilities, and promote respectful and effective action and relationships. Drawn from a range of sources, the framework provides a vocabulary and narrative structure for examining the moral (...) dimensions of providing development or humanitarian health assistance to individuals and communities, and working with and alongside local and international actors. The elements also help minimize or avoid certain miscalculations and harms. Emphasis is placed on the shared humanity of those who provide and those who receive assistance, acknowledgement of limits and risks related to the contributions of expatriate health care professionals, and the importance of providing skillful and relevant assistance. These elements articulate a moral posture for expatriate health care professionals that contributes to orienting the practice of clinicians in ways that reflect respect, humility, and solidarity. Health care professionals whose understanding and actions are consistent with the ethics of engaged presence will be oriented toward introspection and reflective practice and toward developing, sustaining and promoting collaborative partnerships. (shrink)

BackgroundWhile evaluation of ethical aspects in health technology assessment has gained much attention during the past years, the integration of ethics in HTA practice still presents many challenges. In response to the increasing demand for expansion of health technology assessment methodology to include ethical issues more systematically, this article reports on a multi-stage study that aimed at construction of a framework for improving the integration of ethics in HTA.MethodsThe framework was developed through the following phases: 1) a systematic review and (...) content analysis of guidance documents for ethics in HTA; 2) identification of factors influencing the integration of ethical considerations in HTA; 3) preparation of an action-oriented framework based on the key elements of the existing guidance documents and identified barriers to and facilitators of their implementation; and 4) expert consultation and revision of the framework.ResultsThe proposed framework consists of three main components: an algorithmic flowchart, which exhibits the different steps of an ethical inquiry throughout the HTA process, including: defining the objectives and scope of the evaluation, stakeholder analysis, assessing organizational capacity, framing ethical evaluation questions, ethical analysis, deliberation, and knowledge translation; a stepwise guide, which focuses on the task objectives and potential questions that are required to be addressed at each step; and a list of some commonly recommended or used tools to help facilitate the evaluation process.ConclusionsThe proposed framework can be used to support and promote good practice in integration of ethics into HTA. However, further validation of the framework through case studies and expert consultation is required to establish its utility for HTA practice. (shrink)

The Médecins Sans Frontières ethics review board has been solicited in an unprecedented way to provide advice and review research protocols in an ‘emergency’ mode during the recent Ebola epidemic. Twenty-seven Ebola-related study protocols were reviewed between March 2014 and August 2015, ranging from epidemiological research, to behavioural research, infectivity studies and clinical trials with investigational products at early development stages. This article examines the MSF ERB’s experience addressing issues related to both the process of review and substantive ethical issues (...) in this context. These topics include lack of policies regarding blood sample collection and use, and engaging communities regarding their storage and future use; exclusion of pregnant women from clinical and vaccine trials; and the difficulty of implementing timely and high-quality qualitative/anthropological research to consider potential upfront harms. Having noticed different standards across ethics committees, we propose that when multiple ethics reviews of clinical and vaccine trials are carried out during a public health emergency they should be accompanied by transparent communication between the ECs involved. The MSF ERB experience should trigger a broader discussion on the ‘optimal’ ethics review in an emergency outbreak and what enduring structural changes are needed to improve the ethics review process. (shrink)

While evaluation of ethical aspects in health technology assessment has gained much attention during the past years, the integration of ethics in HTA practice still presents many challenges. In response...

Non-Invasive Prenatal Testing is a technology which provides information about fetal genetic characteristics very early in pregnancy by examining fetal DNA obtained from a sample of maternal blood. NIPT is a morally complex technology that has advanced quickly to market with a strong push from industry developers, leaving many areas of uncertainty still to be resolved, and creating a strong need for health policy that reflects women’s social and ethical values. We approach the need for ethical policy-making by studying the (...) use of NIPT and emerging policy in the province of Ontario, Canada. Using an adapted version of constructivist grounded theory, we conducted interviews with 38 women who have had personal experiences with NIPT. We used an iterative process of data collection and analysis and a staged coding strategy to conduct a descriptive analysis of ethics issues identified implicitly and explicitly by women who have been affected by this technology. The findings of this paper focus on current ethical issues for women seeking NIPT, including place in the prenatal pathway, health care provider counselling about the test, industry influence on the diffusion of NIPT, consequences of availability of test results. Other issues gain relevance in the context of future policy decisions regarding NIPT, including funding of NIPT and principles that may govern the expansion of the scope of NIPT. These findings are not an exhaustive list of all the potential ethical issues related to NIPT, but rather a representation of the issues which concern women who have personal experience with this test. Women who have had personal experience with NIPT have concerns and priorities which sometimes contrast dramatically with the theoretical ethics literature. These findings suggest the importance of engaging patients in ethical deliberation about morally complex technologies, and point to the need for more deliberative patient engagement work in this area. (shrink)

Research involving migrant youth involves navigating and negotiating complex challenges in order to uphold their rights and dignity, but also all while maintaining scientific rigour. COVID-19 has changed the global landscape within many domains and has increasingly highlighted inequities that exist. With restrictions focusing on maintaining physical distancing set in place to curb the spread of the virus, conducting in-person research becomes complicated. This article reflects on the ethical and methodological challenges encountered when conducting qualitative research during the pandemic with (...) Syrian migrant youth who are resettled in Canada. The three areas discussed from the study are recruitment, informed consent and managing the interviews. Special attention to culture as being part of the study’s methodology as an active reflexive process is also highlighted. The goal of this article is to contribute to the growing understanding of complexities of conducting research during COVID-19 with populations which have layered vulnerabilities, such as migrant youth. This article hopes that the reflections may help future researchers in conducting their research during this pandemic by being cognizant of both the ethical and methodological challenges discussed. (shrink)

The way in which medical professionals engage in bioethical issues ultimately reflects the type of care such patients are likely to receive. It is therefore critical for doctors and other health care professionals to have a broad understanding of disability. Our purpose in this paper is to explore ways of teaching bioethical issues to first year medical students by integrating alternative approaches. Such approaches include (a) the use of the narrative format, (b) the inclusion of a disability perspective, and (c) (...) the presentation and facilitation of classes by people with disabilities. We consider how these new kinds of presentations are evaluated by students, faculty, people with disabilities and professional ethicists. We hope new knowledge may provide health care professionals with a greater understanding of the perspectives of patients with disabilities, who are confronted by conflicting ethical values and frameworks for decision-making in their interaction with such professionals. (shrink)

The humanitarian sector continually faces organizational and operational challenges to respond to the needs of populations affected by war, disaster, displacement, and health emergencies. With the goal of improving the effectiveness and efficiency of response efforts, humanitarian innovation initiatives seek to develop, test, and scale a variety of novel and adapted practices, products, and systems. The innovation process raises important ethical considerations, such as appropriately engaging crisis-affected populations in defining problems and identifying potential solutions, mitigating risks, ensuring accountability, sharing benefits (...) fairly, and managing expectations. This paper aims to contribute to knowledge and practice regarding humanitarian innovation ethics and presents two components related to a value-sensitive approach to humanitarian innovation. First is a mapping of how ethical concepts are mobilized in values statements that have been produced by a diverse set of organizations involved in humanitarian innovation. Analyzing these documents, we identified six primary values (do-no-harm, autonomy, justice, accountability, sustainability, and inclusivity) around which we grouped 12 secondary values and 10 associated concepts. Second are two proposed activities that teams engaged in humanitarian innovation can employ to foreground values as they develop and refine their project’s design, and to anticipate and plan for challenges in enacting these values across the phases of their project. A deliberate and tangible approach to engaging with values within humanitarian innovation design can help to ground humanitarian innovation in ethical commitments by increasing shared understanding amongst team members, promoting attentiveness to values across the stages of innovation, and fostering capacities to anticipate and respond to ethically challenging situations. (shrink)

The conduct of research in settings affected by disasters such as hurricanes, floods and earthquakes is challenging, particularly when infrastructures and resources were already limited pre-disaster. However, since post-disaster research is essential to the improvement of the humanitarian response, it is important that adequate research ethics oversight be available. We aim to answer the following questions: 1) what do research ethics committee members who have reviewed research protocols to be conducted following disasters in low- and middle-income countries perceive as the (...) key ethical concerns associated with disaster research?, and 2) in what ways do REC members understand these concerns to be distinct from those arising in research conducted in non-crisis situations? This qualitative study was developed using interpretative description methodology; 15 interviews were conducted with REC members. Four key ethical issues were identified as presenting distinctive considerations for disaster research to be implemented in LMICs, and were described by participants as familiar research ethics issues that were amplified in these contexts. First, REC members viewed disaster research as having strong social value due to its potential for improving disaster response, but also as requiring a higher level of justification compared to other research settings. Second, they identified vulnerability as an overarching concern for disaster research ethics, and a feature that required careful and critical appraisal when assessing protocols. They noted that research participants’ vulnerabilities frequently change in the aftermath of a disaster and often in unpredictable ways. Third, they identified concerns related to promoting and maintaining safety, confidentiality and data security in insecure or austere environments. Lastly, though REC members endorsed the need and usefulness of community engagement, they noted that there are significant challenges in a disaster setting over and above those typically encountered in global health research to achieve meaningful community engagement. Disaster research presents distinctive ethical considerations that require attention to ensure that participants are protected. As RECs review disaster research protocols, they should address these concerns and consider how justification, vulnerability, security and confidentially, and community engagement are shaped by the realities of conducting research in a disaster. (shrink)

BackgroundThe role of consent for research use of health information is contentious. Most discussion has focused on when project-specific consent may be waived but, recently, a broader range of consent options has been entertained, including broad opt-in for multiple studies with restrictions and notification with opt-out. We sought to elicit public values in this matter and to work toward an agreement about a common approach to consent for use of personal information for health research through deliberative public dialogues.MethodsWe conducted seven (...) day-long public dialogues, involving 98 participants across Canada. Immediately before and after each dialogue, participants completed a fixed-response questionnaire rating individuals' support for 3 approaches to consent in the abstract and their consent choices for 5 health research scenarios using personal information. They also rated how confident different safeguards made them feel that their information was being used responsibly.ResultsBroad opt-in consent for use of personal information garnered the greatest support in the abstract. When presented with specific research scenarios, no one approach to consent predominated. When profit was introduced into the scenarios, consent choices shifted toward greater control over use. Despite lively and constructive dialogues, and considerable shifting in opinion at the individual level, at the end of the day, there was no substantive aggregate movement in opinion. Personal controls were among the most commonly cited approaches to improving people's confidence in the responsible use of their information for research.ConclusionBecause no one approach to consent satisfied even a simple majority of dialogue participants and the importance placed on personal controls, a mechanism should be developed for documenting consent choice for different types of research, including ways for individuals to check who has accessed their medical record for purposes other than clinical care. This could be done, for example, through a web-based patient portal to their electronic health record. Researchers and policy makers should continue to engage the public to promote greater public understanding of the research process and to look for feasible alternatives to existing approaches to project-specific consent for observational research. (shrink)

BackgroundThe amount of research utilizing health information has increased dramatically over the last ten years. Many institutions have extensive biobank holdings collected over a number of years for clinical and teaching purposes, but are uncertain as to the proper circumstances in which to permit research uses of these samples. Research Ethics Boards (REBs) in Canada and elsewhere in the world are grappling with these issues, but lack clear guidance regarding their role in the creation of and access to registries and (...) biobanks.MethodsChairs of 34 REBS and/or REB Administrators affiliated with Faculties of Medicine in Canadian universities were interviewed. Interviews consisted of structured questions dealing with diabetes-related scenarios, with open-ended responses and probing for rationales. The two scenarios involved the development of a diabetes registry using clinical encounter data across several physicians' practices, and the addition of biological samples to the registry to create a biobank.ResultsThere was a wide range of responses given for the questions raised in the scenarios, indicating a lack of clarity about the role of REBs in registries and biobanks. With respect to the creation of a registry, a minority of sites felt that consent was not required for the information to be entered into the registry. Whether patient consent was required for information to be entered into the registry and the duration for which the consent would be operative differed across sites. With respect to the creation of a biobank linked to the registry, a majority of sites viewed biobank information as qualitatively different from other types of personal health information. All respondents agreed that patient consent was needed for blood samples to be placed in the biobank but the duration of consent again varied.ConclusionParticipants were more attuned to issues surrounding biobanks as compared to registries and demonstrated a higher level of concern regarding biobanks. As registries and biobanks expand, there is a need for critical analysis of suitable roles for REBs and subsequent guidance on these topics. The authors conclude by recommending REB participation in the creation of registries and biobanks and the eventual drafting of comprehensive legislation. (shrink)

BackgroundStigma refers to a distinguishing personal trait that is perceived as or actually is physically, socially, or psychologically disadvantageous. Little is known about the opinion of those who have more or less stigmatizing health conditions regarding the need for consent for use of their personal information for health research.MethodsWe surveyed the opinions of people 18 years and older with seven health conditions. Participants were drawn from: physicians' offices and clinics in southern Ontario; and from a cross-Canada marketing panel of individuals (...) with the target health conditions. For each of five research scenarios presented, respondents chose one of five consent choices: (1) no need for me to know; (2) notice with opt-out; (3) broad opt-in; (4) project-specific permission; and (5) this information should not be used. Consent choices were regressed onto: demographics; health condition; and attitude measures of privacy, disclosure concern, and the benefits of health research. We conducted focus groups to discuss possible reasons for observed consent choices.ResultsWe observed substantial variation in the control that people wish to have over use of their personal information for research. However, consent choice profiles were similar across health conditions, possibly due to sampling bias. Research involving profit or requiring linkage of health information with income, education, or occupation were associated with more restrictive consent choices. People were more willing to link their health information with biological samples than with information about their income, occupation, or education.ConclusionsThe heterogeneity in consent choices suggests individuals should be offered some choice in use of their information for different types of health research, even if limited to selectively opting-out. Some of the implementation challenges could be designed into the interoperable electronic health record. However, many questions remain, including how best to capture the opinions of those who are more privacy sensitive. (shrink)

It is clear that in the eyes of a growing number of humanitarian fieldworkers and decision-makers, palliative care is something humanitarian organizations should strive to provide as they address the needs of populations affected by crises. What remains less clear are the moral justifications underlying the push to do so. This chapter dives beneath surface prescriptions of what “ought to be” the place of palliative care within humanitarian response. It presents and analyses a series of evocative statements made by 24 (...) humanitarian healthcare actors about why, on what bases, and with what caveats, care for the dying deserves more attention within humanitarian healthcare response. Embedded in these statements are sometimes explicit, sometimes implicit ideas about what it means be a human and a humanitarian, and what humans need and deserve. Clarifying the experiences, practical considerations, understandings of care and responsibility, and norms and values underlying these feelings renders these available for more thorough reflection, discussion, and debate. (shrink)

In 2016, following pandemic influenza threats and the 2014–2016 Ebola virus disease outbreaks, the WHO developed a guidance document for managing ethical issues in infectious disease outbreaks. In this article, we analyse some ethical issues that have had a predominant role in decision making in response to the current COVID-19 pandemic but were absent or not addressed in the same ways in the 2016 guidance document. A pandemic results in a health crisis and social and political crises both nationally and (...) globally. The ethical implications of these global effects should be properly identified so that appropriate actions can be taken globally and not just in national isolation. Our analysis, which is a starting point to test the broader relevance of the 2016 WHO document that remains the only available guidance document applicable globally, concludes that the WHO guidance should be updated to provide reasoned and thoughtful comprehensive ethics advice for the sound management of the current and future pandemics. (shrink)

`Being sensitive' in nursing was explored using Schwartz-Barcott and Kim's hybrid model of concept development, producing a tentative definition of the concept. Three phases were employed: theoretical, empirical/fieldwork and analytical. An exploration of the literature identified where the common idea of `being sensitive' as a nurse was embedded and demonstrated that a theoretical development of this fundamental aspect of nursing was absent. The empirical phase was conducted using semistructured interviews with nine expert palliative care and cancer nurses. This method (...) was particularly useful for the exploration of this concept because of its firm grounding in practical example. A definition of what the concept `being sensitive' means in nursing, and subsequent clarification of `being insensitive', have been posed from the research process undertaken. The essential nature of this concept being integral to nursing practice is emphasized. Potential implications for the development of nursing practice through teaching of this concept were identified. (shrink)

Examines the development of the philosophy, culture, and civilization of ancient China and discusses the history of Taoism and Confucianism.

A new theory of how the brain constructs emotions that could revolutionize psychology, health care, law enforcement, and our understanding of the human mind Emotions feel automatic, like uncontrollable reactions to things we think and experience. Scientists have long supported this assumption by claiming that emotions are hardwired in the body or the brain. Today, however, the science of emotion is in the midst of a revolution on par with the discovery of relativity in physics and natural selection in biology--and (...) this paradigm shift has far-reaching implications for us all. Leading the charge is psychologist and neuroscientist Lisa Feldman Barrett, whose theory of emotion is driving a deeper understanding of the mind and brain, and shedding new light on what it means to be human. Her research overturns the widely held belief that emotions are housed in different parts of the brain and are universally expressed and recognized. Instead, she has shown that emotion is constructed in the moment, by core systems that interact across the whole brain, aided by a lifetime of learning. This new theory means that you play a much greater role in your emotional life than you ever thought. Its repercussions are already shaking the foundations not only of psychology but also of medicine, the legal system, child-rearing, meditation, and even airport security. Why do emotions feel automatic? Does rational thought really control emotion? How does emotion affect disease? How can you make your children more emotionally intelligent? How Emotions Are Made answers these questions and many more, revealing the latest research and intriguing practical applications of the new science of emotion, mind, and brain. (shrink)

This paper explains how the practice of ‘no platforming’ can be reconciled with a liberal politics. While opponents say that no platforming flouts ideals of open public discourse, and defenders see it as a justifiable harm-prevention measure, both sides mistakenly treat the debate like a run-of-the-mill free speech conflict, rather than an issue of academic freedom specifically. Content-based restrictions on speech in universities are ubiquitous. And this is no affront to a liberal conception of academic freedom, whose purpose isn’t just (...) to protect the speech of academics, but also to give them the prerogative to determine which views and speakers have sufficient disciplinary credentials to receive a hearing in academic contexts. No platforming should therefore be acceptable to liberals, in principle, in cases where it is used to support a university culture that maintains rigorous disciplinary standards, by denying attention and credibility to speakers without appropriate disciplinary credentials. (shrink)

Psychological construction constitutes a different paradigm for the scientific study of emotion when compared to the current paradigm that is inspired by faculty psychology. This new paradigm is more consistent with the post-Darwinian conceptual framework in biology that includes a focus on (a) population thinking (vs. typologies), (b) domain-general core systems (vs. physical essences), and (c) constructive analysis (vs. reductionism). Three psychological construction approaches (the OCC model, the iterative reprocessing model, and the conceptual act theory) are discussed with respect to (...) these ideas. (shrink)

In a recent paper in this journal, McIntosh ( 2021 ) argues that a modalized version of an epistemic principle of phenomenal conservativism can be used to successfully defend the key possibility premise of the modal ontological argument for the existence of God. I argue, however, that such a defense of the possibility premise is not going to be successful even if one concedes a number of contentious claims to McIntosh.

Some claim that moral factors affect the epistemic status of our beliefs. Call this _the moral encroachment thesis_. It’s been argued that the moral encroachment thesis can explain at least part of the wrongness of racial profiling. The thesis predicts that the high moral stakes in cases of racial profiling make it more difficult for these racist beliefs to be justified or to constitute knowledge. This paper considers a class of racial generalizations that seem to do just the opposite of (...) this. The high moral stakes of the beliefs we infer from these generalizations make it _easier_ rather than _harder_ for these beliefs to be justified or to constitute knowledge. I argue that the existence of this class of cases—cases of “positive profiling”—give us reason to expand our account of moral encroachment in a way that brings it closer to the ideal of pragmatic encroachment that motivates it in the first place. (shrink)

The verb to legitimate is often used in political discourse in a way that is prima facie perplexing. To wit, it is often said that an actor legitimates a practice which is officially prohibited in the relevant context – for example, that a worker telling sexist jokes legitimates sex discrimination in the workplace. In order to clarify the meaning of statements like this, and show how they can sometimes be true and informative, we need an explanation of how something that (...) is officially illegitimate can have a kind of ersatz legitimacy conferred on it, and how this can occur even when the actor ‘doing the legitimating’ lacks formal authority. I examine one putative explanation centred around the phenomenon of normalization, and I highlight some advantages that this account has in comparison to an alternative explanation, one that makes reference to the phenomenon of licensed authority. (shrink)

The standard view of academic freedom and free speech is that they play complementary roles in universities. Academic freedom protects academic discourse, while other public discourse in universities is protected by free speech. Here I challenge this view, broadly, on the grounds that free speech in universities sometimes undermines academic practices. One defense of the standard view, in the face of this worry, says that campus free speech actually furthers the university’s academic aims. Another says that universities have a secondary (...) democratic function, which cannot be fulfilled without free speech on campus. I identify shortcomings in both types of arguments. (shrink)

The Negation Problem states that expressivism has insufficient structure to account for the various ways in which a moral sentence can be negated. We argue that the Negation Problem does not arise for expressivist accounts of all normative language but arises only for the specific examples on which expressivists usually focus. In support of this claim, we argue for the following three theses: 1) a problem that is structurally identical to the Negation Problem arises in non-normative cases, and this problem (...) is solved once the hidden quantificational structure involved in such cases is uncovered; 2) the terms ‘required’, ‘permissible’, and ‘forbidden’ can also be analyzed in terms of hidden quantificational structure, and the Negation Problem disappears once this hidden structure is uncovered; 3) the Negation Problem does not arise for normative language that has no hidden quantificational structure. We conclude that the Negation Problem is not really a problem about expressivism at all but is rather a feature of the quantificational structure of the required, permitted, and forbidden. (shrink)

Philosophers are interested in the phenomenon of thought insertion because it challenges the common assumption that one can ascribe to oneself the thoughts that one can access first-personally. In the standard philosophical analysis of thought insertion, the subject owns the ‘inserted’ thought but lacks a sense of agency towards it. In this paper we want to provide an alternative analysis of the condition, according to which subjects typically lack both ownership and authorship of the ‘inserted’ thoughts. We argue that by (...) appealing to a failure of ownership and authorship we can describe more accurately the phenomenology of thought insertion, and distinguish it from that of non-delusional beliefs that have not been deliberated about, and of other delusions of passivity. We can also start developing a more psychologically realistic account of the relation between intentionality, rationality and self knowledge in normal and abnormal cognition. (shrink)

When cognitive scientists are looking for the neural basis of consciousness or the computational processes underlying vision, what are they looking to find? I argue for a new account of this explanatory project in cognitive science (and the special sciences more generally) on which it is best understood on close analogy with causal explanation in the special sciences. Causal explanations cite causal difference-makers: they explain how certain events causally depend on other events. Generative explanations cite generative difference-makers: they explain how (...) certain events obtain in virtue of (and so are generated by) other events. I show how that this generative difference-making account (GDM) extends well regarded developments in philosophical work on causal explanation, helps to usefully clarify and expands the hypothesis space of a key project in cognitive science – that of understanding how underlying nonmental processes give rise to the mental, including consciousness. In section 2, I develop GDM by close analogy with causal explanation, and locate both of them as species of a more general project in the special sciences: that of discovering what makes a difference to what. In section 3, I motivate GDM by contrasting it with other rival accounts, including correlationist, identity, and grounding accounts, as well as Carl Craver’s constitutive relevance account. In section 4, I tie all of the strands of the preceding discussion together to show how GDM provides a new and compelling response to the so-called hard problem of consciousness. (shrink)

George Berkeley, Bishop of Cloyne, was one of the great philosophers of the early modern period. He was a brilliant critic of his predecessors, particularly Descartes, Malebranche, and Locke. He was a talented metaphysician famous for defending idealism, that is, the view that reality consists exclusively of minds and their ideas. Berkeley's system, while it strikes many as counter intuitive, is strong and flexible enough to counter most objections. His most studied works, the Treatise Concerning the Principles of Human Knowledge (...) Principles, for short) and Three Dialogues between Hylas and Philonous Dialogues), are beautifully written and dense with the sort of arguments that delight contemporary philosophers. He was also a wide ranging thinker with interests in religion (which were fundamental to his philosophical motivations), the psychology of vision, mathematics, physics, morals, economics, and medicine. Although many of Berkeley's first readers greeted him with incomprehension, he influenced both Hume and Kant, and is much read (if little followed) in our own day. (shrink)

Permissivism says that for some propositions and bodies of evidence, there is more than one rationally permissible doxastic attitude that can be taken towards that proposition given the evidence. Some critics of this view argue that it condones, as rationally acceptable, sets of attitudes that manifest an untenable kind of arbitrariness. I begin by providing a new and more detailed explication of what this alleged arbitrariness consists in. I then explain why Miriam Schoenfield’s prima facie promising attempt to answer the (...) Arbitrariness Objection, by appealing to the role of epistemic standards in rational belief formation, fails to resolve the problem. Schoenfield’s strategy is, however, a useful one, and I go on to explain how an alternative form of the standards-based approach to Permissivism – one that emphasizes the significance of the relationship between people’s cognitive abilities and the epistemic standards that they employ – can respond to the arbitrariness objection. (shrink)

The last two decades have seen two significant trends emerging within the philosophy of science: the rapid development and focus on the philosophy of the specialised sciences, and a resurgence of Aristotelian metaphysics, much of which is concerned with the possibility of emergence, as well as the ontological status and indispensability of dispositions and powers in science. Despite these recent trends, few Aristotelian metaphysicians have engaged directly with the philosophy of the specialised sciences. Additionally, the relationship between fundamental Aristotelian concepts—such (...) as "hylomorphism", "substance", and "faculties"—and contemporary science has yet to receive a critical and systematic treatment. _Neo-Aristotelian Perspectives on Contemporary Science _aims to fill this gap in the literature by bringing together essays on the relationship between Aristotelianism and science that cut across interdisciplinary boundaries. The chapters in this volume are divided into two main sections covering the philosophy of physics and the philosophy of the life sciences. Featuring original contributions from distinguished and early-career scholars, this book will be of interest to specialists in analytical metaphysics and the philosophy of science. (shrink)

This book offers a balanced and comprehensive account of philosophical thought from the middle of the fourteenth century to the emergence of modern philosophy at the turn of the seventeenth century.

Locke’s metaphysical commitments are a matter of some controversy. Further controversy attends the issue of whether and how Locke adapts his views in order to accommodate the success of Newton’s Principia. The chapter lays out an interpretation of Locke’s commitments according to which Locke’s response to Newton on gravity does not require the positing of brute powers and is consistent with his core essentialism. The chapter raises the question of how the hypothesis concerning the creation of matter, alluded to at (...) 4.10.18, fits with these commitments. The chapter concludes that the De grav hypothesis would represent a significant revision to the background metaphysical picture of the Essay, but that nevertheless its attractions to Locke are intelligible and illuminating. (shrink)

Proponents of the view which I call ‘moral antitheodicy’ call for the theistic discourse of theodicy to be abandoned, because, they claim, all theodicies involve some form of moral impropriety. Three arguments in support of this view are examined: the argument from insensitivity, the argument from detachment, and the argument from harmful consequences. After discussing the merits of each argument individually, I attempt to show that they all must presuppose what they are intended to establish, namely, that the set of (...) premises advanced in any given theodicy will be untenable. I conclude by discussing what uses there might be for the moral critique of theodicy, if it cannot be used to ground a global rejection of theodical practice. (shrink)

This paper argues that a priori justification is, in principle, compatible with naturalism—if the a priori is understood in a way that is free of the inessential properties that, historically, have been associated with the concept. I argue that empirical indefeasibility is essential to the primary notion of the a priori ; however, the indefeasibility requirement should be interpreted in such a way that we can be fallibilist about apriori-justified claims. This fallibilist notion of the a priori accords with the (...) naturalist’s commitment to scientific methodology in that it allows for apriori-justified claims to be sensitive to further conceptual developments and the expansion of evidence. The fallibilist apriorist allows that an a priori claim is revisable in only a purely epistemic sense. This modal claim is weaker than what is required for a revisability thesis to establish empiricism, so fallibilist apriorism represents a distinct position. (shrink)

This paper examines two recent contributions to the hate speech literature – by Steven Heyman and Jeremy Waldron – which seek a justification for the legal restriction of hate speech in an account of the way that hate speech infringes against people’s dignity. These analyses look beyond the first-order hurts and disadvantages suffered by the immediate targets of hate speech, and consider the prospect of hate speech sustaining complex social structures whose wide-scale operations lower the social status of members of (...) targeted groups. In Heyman’s and Waldron’s accounts we find plausible insights into the nature of identity-based social hierarchies, and the harms that redound to subordinated people under the operations of such hierarchies. I argue, however, that both analyses are unsuccessful as justifications for the restriction of hate speech, because they do not ultimately provide reason to think that hate speech is responsible for creating or sustaining identity-based social hierarchies. (shrink)

Includes bibliographical references and index.