Gregory Poore

Cancers rely on multiple, heterogeneous processes at different scales, pertaining to many biomedical fields. Therefore, understanding cancer is necessarily an interdisciplinary task that requires placing specialised experimental and clinical research into a broader conceptual, theoretical, and methodological framework. Without such a framework, oncology will collect piecemeal results, with scant dialogue between the different scientific communities studying cancer. We argue that one important way forward in service of a more successful dialogue is through greater integration of applied sciences (experimental and clinical) with conceptual and theoretical approaches, informed by philosophical methods. By way of illustration, we explore six central themes: (i) the role of mutations in cancer; (ii) the clonal evolution of cancer cells; (iii) the relationship between cancer and multicellularity; (iv) the tumour microenvironment; (v) the immune system; and (vi) stem cells. In each case, we examine open questions in the scientific literature through a philosophical methodology and show the benefit of such a synergy for the scientific and medical understanding of cancer.

The unexpected roles of the microbiota in cancer challenge explanations of carcinogenesis that focus on tumor-intrinsic properties. Most tumors contain bacteria and viruses, and the host’s proximal and distal microbiota influence both cancer incidence and therapeutic responsiveness. Continuing the history of cancer–microbe research, these findings raise a key question: to what extent is the microbiota relevant for clinical oncology? We approach this by critically evaluating three issues: how the microbiota provides a predictive biomarker of cancer growth and therapeutic responsiveness, the microbiota’s causal role(s) in cancer development, and how therapeutic manipulations of the microbiota improve patient outcomes in cancer. Clarifying the conceptual and empirical aspects of the cancer-associated microbiota can orient future research and guide its implementation in clinical oncology.

The presence and role of microbes in human cancers has come full circle in the last century. Tumors are no longer considered aseptic, but implications for cancer biology and oncology remain underappreciated. Opportunities to identify and build translational diagnostics, prognostics, and therapeutics that exploit cancer's second genome—the metagenome—are manifold, but require careful consideration of microbial experimental idiosyncrasies that are distinct from host‐centric methods. Furthermore, the discoveries of intracellular and intra‐metastatic cancer bacteria necessitate fundamental changes in describing clonal evolution and selection, reflecting bidirectional interactions with non‐human residents. Reconsidering cancer clonality as a multispecies process similarly holds key implications for understanding metastasis and prognosing therapeutic resistance while providing rational guidance for the next generation of bacterial cancer therapies. Guided by these new findings and challenges, this Review describes opportunities to exploit cancer's metagenome in oncology and proposes an evolutionary framework as a first step towards modeling multispecies cancer clonality. Also see the video abstract here: https://youtu.be/-WDtIRJYZSs.

On the standard simple foundationalist interpretation of Thomas Reid’s epistemology, his epistemic appeals to God seem problematic. These appeals are generally dismissed as dogmatic, viciously circular, or mere irrelevant pieties. This chapter responds first that, even on the standard foundationalist interpretation, theism can sometimes boost the epistemic justification of first principles. It then argues that Reid’s epistemology is plausibly interpreted as containing coherentist strands. While not generally necessary for knowledge, coherence can boost the justification of our basic beliefs, and this boost in justification can be valuable in certain contexts. Because many of Reid’s epistemic appeals to God—including those that are viciously circular on the standard interpretation—are coherence-generating, this interpretation provides a plausible explanation for how theism can boost the justification of various first principles, including first principles about the reliability of our faculties.

The role of theism in Thomas Reid’s epistemology remains an unresolved question. Opinions range from outright denials that theism has any relevance to Reid’s epistemology to claims that Reid’s epistemology depends upon theism in a dogmatic or a viciously circular manner. This dissertation attempts to bring some order to this interpretive fray by answering the following question: What role or roles does theism play in Reid’s epistemology, particularly in relation to the epistemic justification of first principles? Chapters 2-4 lay the foundation for answering this question and clarify some terminology. Chapter 2 distinguishes key senses in which Reid uses the terms “principle” and “first principle.” Chapter 3 argues for a novel interpretation of common sense and the principles of common sense. This interpretation avoids a number of objections to Reid’s principles of common sense. Chapter 4 considers the initial externalist justification of Reid’s first principles. It shows Reid has a surprisingly well-developed proper-functionalism and brings to light several overlooked elements of his epistemology. Chapters 5-8 argue theism can and does play various important and philosophically respectable roles in Reid’s epistemology, particularly in relation to the justification of first principles. Chapter 5 argues that even on the standard foundationalist interpretation of Reid’s epistemology, theism can and does boost the justification of first principles. Chapter 6 shows Reid’s epistemology is not a form of simple foundationalism but contains coherentist elements. This enables theism further to boost the justification of first principles. Chapter 7 reveals that Reid’s epistemology contains different kinds or levels of knowledge, and shows that theism enables the highest form of knowledge, which I call scientia. Chapter 8 argues that within Reid’s epistemology theism helps protect and preserve the justification of first principles.

In Dependent Rational Animals, Alasdair MacIntyre attempts to ground the virtues in a biological account of humans. Drawing from this attempt, he also tries to answer the question of why we should care for the severely disabled. MacIntyre’s difficulty in answering this question begins with the fact that his communities of practices do not naturally include the severely disabled within their membership and care. In response to this difficulty, he provides four reasons for why we should care for the severely disabled. I argue that three of these reasons are inadequate, and that the fourth is incomplete although it does point in a promising direction. I conclude that a more satisfactory answer requires a further extension of the central development from After Virtue to Dependent Rational Animals, and I draw from Wendell Berry, whose work MacIntyre admires, to provide an illuminating illustration of what such an answer might look like

Reading and reflecting on real cases helps ethics come alive for students. Good cases grip our attention, engage our imagination, and show the real-life implications of abstract ethical theories, ideals, commitments, and policies. Finding good case studies is both difficult and time-consuming for instructors, so I was excited to learn about Glenn McGee’s book Bioethics for Beginners: 60 Cases and Cautions from the Moral Frontier of Healthcare. According to the publisher, its target audiences are “courses in bioethics, medical ethics, and applied ethics.” The book sounded promising.McGee’s book contains ten chapters, or “cautions,” plus a conclusion. Each chapter consists of anywhere from three to nine loosely associated “cases.” The cases average about one and a half pages each, but they vary significantly in length. The shortest cases are less than a page while the longest is twelve pages .All sixty cases, as well as the two sections that compose the conclus ..