Patient centred diagnosis is best practised through shared decision making; an iterative dialogue between doctor and patient, whichrespects a patient’s needs, values, preferences, and circumstances. -/- Shared decision making for diagnostic situations differs fundamentally from that for treatment decisions. This has important implications when considering its practical application. -/- The nature of dialogue should be tailored to the specific diagnostic decision; scenarios with higher stakes or uncertainty usually require more detailed conversations.

This paper is a study about Philadelphia’s comprehensive user engagement sites (CUESs) as the authors address and examine issues related to the upcoming implementation of a CUES while seeking solutions for its disputed questions and plans. Beginning with the federal drug schedules, the authors visit some of the medical and public health issues vis-à-vis safe injection facilities (SIFs). Insite, a successful Canadian SIF, has been thoroughly researched as it represents a paradigm for which a Philadelphia CUES can expand upon. Also, (...) the existing criticisms against SIFs are revisited while critically unpackaged and responded to in favor of the establishment. In the main section, the authors propose the layout and services of the upcoming CUES, much of which would be in congruent to Vancouver’s Insite. On the other hand, the CUES would be distinct from Insite, as the authors emphasize, in that it will offer an information center run by individuals in recovery and place additional emphasis on early education for young healthcare professionals by providing them a platform to work at the site. The paper will also briefly investigate the implementation of a CUES site under an ethical scope of the Harm Reduction Theory. Lastly, the authors recommend some strategic plans that the Philadelphia City government may consider employing at this crucial stage. (shrink)

This chapter describes the potential far‐reaching consequences of contemplative higher education for the fields of science and medicine.

REMARKS ON EVOLUTION AND TIME-SCALES, Graham Cairns-Smith; HODGSON'S BLACK BOX, Thomas Clark; DO HODGSON'S PROPOSITIONS UNIQUELY CHARACTERIZE FREE WILL?, Ravi Gomatam; WHAT SHOULD WE RETAIN FROM A PLAIN PERSON'S CONCEPT OF FREE WILL?, Gilberto Gomes; ISOLATING DISPARATE CHALLENGES TO HODGSON'S ACCOUNT OF FREE WILL, Liberty Jaswal; FREE AGENCY AND LAWS OF NATURE, Robert Kane; SCIENCE VERSUS REALIZATION OF VALUE, NOT DETERMINISM VERSUS CHOICE, Nicholas Maxwell; COMMENTS ON HODGSON, J.J.C. Smart; THE VIEW FROM WITHIN, Sean Spence; COMMENTARY ON HODGSON, Henry Stapp.

Initial responses to questionnaires used to assess participants' understanding of informed consent for malaria vaccine trials conducted in the United States and Mali were tallied. Total scores were analyzed by age, sex, literacy (if known), and location. Ninety-two percent (92%) of answers by United States participants and 85% of answers by Malian participants were correct. Questions more likely to be answered incorrectly in Mali related to risk, and to the type of vaccine. For adult participants, independent predictors of higher scores (...) were younger age and female sex in the United States, and male sex in Mali. Scores in the United States were higher than in Mali (P = 0.005). Despite this difference participants at both sites were well informed overall. Although interpretation must be qualified because questionnaires were not intended as research tools and were not standardized among sites, these results do not support concerns about systematic low understanding among research participants in developing versus developed countries. (shrink)

This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper "Biomedical Informatics: We Are What We Publish", written by Peter L. Elkin, Steven H. Brown, and Graham Wright. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the Elkin et al. paper. In subsequent issues the discussion can continue through letters to the editor.

This paper is about the similarity between the appreciation of a piece of art, such as a cherished music album, and the loving appreciation of a person whom one knows well. In philosophical discussion about the rationality of love, the Qualities View (QV) says that love can be justified by reference to the qualities of the beloved. I argue that the oft-rehearsed trading-up objection fails to undermine the QV. The problems typically identified by the objection arise from the idea that (...) love-worthy qualities could be coarse-grained, when in fact they must be fine-grained. The analogy with appreciation of aesthetic qualities helps to draw out this point. Once the fine-grained nature of love-worthy qualities is properly understood, it is clear that critics of the QV cannot rely on the trading-up objection to motivate its rejection. Moreover, the paper’s core argument helps to illuminate the persistently aesthetic nature of interpersonal affections. (shrink)

The problem considered in this chapter emerges from the tension we find when looking at the design and architecture of chatbots on the one hand and their conversational aptitude on the other. In the way that LLM chatbots are designed and built, we have good reason to suppose they don't possess second-order capacities such as intention, belief or knowledge. Yet theories of conversation make great use of second-order capacities of speakers and their audiences to explain how aspects of interaction succeed. (...) As we can all bear witness to now though, at the point of use chatbots appear capable of performing language tasks at a level close to that of humans. This creates a tension when we consider something like, for example, the classic Gricean theory of implicature. On a broad summary of this type of account, to utter p and implicate q requires the reflexive occurrence of an audience supposing a speaker believes that q, and the speaker believing that their audience can determine they believe it when they utter p. So taken at face value, if a chatbot doesn’t have the capacity for belief, then either in their role as speaker or audience, they would not seem capable of either generating or comprehending implicatures. Yet on the surface it does seem that chatbots are capable of dealing with (some) implicatures, and as such it raises questions about how we should then correlate this with what we think occurs in cases of implicature with chatbots. (shrink)

Culling seems to be a cruel method of human interference in the lives of elephants. The method of culling is generally used to control population numbers of highly developed mammals to protect vegetation and habitat for other less important species. Many people are against human interference in the lives of elephants. In this article aspects of this highly controversial issue are explored. Three fascinating characteristics of this ethical dilemma are discussed in the introductory part, and then the major arguments raised (...) against human interference in the lives of elephants are evaluated. These arguments are the following: First, that nature should be allowed to run its course and establish its own balance; nature will thus solve the problem of elephant overpopulation. The second argument raised by animal-rights activists as well as by animal-welfare groups either claim that animals have rights that humans must respect at all times, or that all sentient beings have interests that humans ought to respect, as those beings can experience pleasure or pain. The third argument often associates culling elephants as method for population control with the commercial use and exploitation of wilderness areas. Many people argue that it is unethical to use wildlife as a sustainable resource for fighting poverty. In conclusion it is stated that despite these arguments human intervention in the lives of elephants are ethically justified. (shrink)

Calls for compensation are heard in many countries all over the world. Spokespersons on behalf of formerly oppressed and dominated groups call for compensation for the deeply traumatic injustices their members have suffered in the past. Sometimes these injustices were suffered decades ago by members already deceased. How valid are such claims to compensation and should they be honoured as a matter of justice? The focus of this essay is on these issues of compensatory justice. I want to look at (...) the issue from the perspective of the eradication of systematic poverty affecting particular groups—where injustices of the distant past can reliably be identified as one of the major contributory factors to people’s current poverty. In the paper I will examine the following issues: (1) What kind of injustices qualify to be remedied by means of compensatory justice? (2) Should there be a limit to how far back in history one should go to compensate for injustice? (3) How can an injustice from the distant past be reliably identified as a cause of current problems? (4) Who should be compensated? (5) Who is responsible for compensation? (6) What form should compensation take? (7) Is the concept of compensatory justice backward looking or forward looking? I will argue for a moral obligation to the effect that serious injustices, perpetrated long ago against a group of people and caused them to be poor, ought to be compensated by society in a variety of ways to the original victims (if still alive) and their descendants. (shrink)

Awareness of, and respect for differences of gender, race, religion, language, and culture have liberated many oppressed groups from the hegemony of white, Western males. However, respect for previously denigrated collective identities should not be allowed to confine individuals to identities constructed around one main component used for political mobilisation, or to identities that depend on a priority of properties that are not optional, like race, gender, and language. In this article I want to sketch an approach for accommodating different (...) kinds of identity within a multicultural constitutional democracy. From a vantage point provided by a definition and explanation of personal identity, I want to show how people define, construct and change their personal identities to make themselves into unique individuals. Next I show how democratic political institutions and the personal identities of individuals reciprocally influence one another. In the final section I sketch ways in which diverse personal identities ought to be accommodated in multicultural constitutional democracies. The conclusion is that a society which gives its members the liberty, space, and opportunity to freely construct their own identities might avoid the formation of closed groups committed exclusively to their own sectional interests. (shrink)

If humans may indeed legitimately intervene in conservation areas to let nature be and to protect the lives of all the diverse individual animals under their care, then the management of elephants must be legitimate as part of the conservation of natural world diversities. If this is so, to what extent are current management options ethically acceptable? In this article I address the ethics of the management options available once the judgement has been made that there are too many elephants (...) in a conservation area. I evaluate the ethical acceptability of four options, i.e., the simulation of nature, translocation, contraception, and culling. I furthermore ask whether the harsh blow of culling under very specific conditions can be softened by the taming and training of African elephants. I then examine the ethics of decision making about these issues. Before I do so, two issues must be discussed that decisively influence the management of elephants. The one is whether it is ethically justifiable to fence in elephants. The second is the ethical requirements of the scientific practice that informs management decisions. In the article I come to the conclusion that all four options are ethically flawed. All four require some violation of the important injunction to let nature be and to treat individual animals with respect. However, to do nothing and allow a loss of other species violates the important goal of conserving natural world diversity. (shrink)

Rawls champions the cause of the poor because of his strong moral sentiments about the eradication of poverty. I present these sentiments, which he converts into normative elements of his theory of justice. However, the conceptual framework and intellectual resources that he uses to articulate these sentiments are inadequate. His sentiments against poverty cannot be accommodated neatly, simply, and coherently in his liberal theoretical framework. Also, I point out that his definition of the identification of poor people as the least (...) advantaged members of society is not adequate. Therefore, his theory is refashioned so that it can properly account for the fundamental interests of poor people. An alternative conception is presented, revising Rawlsian liberalism to enable it to adequately champion the cause of the poor. I provide an alternative definition of poverty and apply Mill’s analysis of the relation between justice and utility to Rawls’ theory of justice. (shrink)

In this article I present an alternative philosophy of science based on ideas drawn from the study of complex adaptive systems. As a result of the spectacular expansion in scientific disciplines, the number of scientists and scientific institutions in the twentieth century, I believe science can be characterised as a complex system. I want to interpret the processes of science through which scientists themselves determine what counts as good science. This characterisation of science as a complex system can give an (...) answer to the question why the sciences are so successful in solving growing numbers of problems and correcting their own mistakes. I utilise components of complexity theory to explain and interpret science as a complex system. I first explain the concept of complexity in ordinary language. The explanation of science as a complex system starts with a definition of the basic rules that guide the behaviour of science as a complex system. Next, I show how various sciences result through the implementation of these rules in the study of a specific aspect of reality. The explanation of the growth of science through evolutionary adaptation and learning forms the core of the article. (shrink)

Can a man be a feminist? If so, what would it mean? I want to participate in a dialogue between women and men on how to accommodate women’s moral concerns. I propose that the fundamental values of justice embodied in the South African constitutional democracy require men to be feminist. These values provide the best safeguard of the important interests and values of both women and men. Men who accept these values can support the main concerns of feminism. The implications (...) of the argument in this article range from public issues to the most private aspects of marriage. (shrink)

The ethical philosophy of Emmanuel Levinas is typically associated with a punishing conception of responsibility rather than freedom. In this chapter, our aim is to explore Levinas’s often overlooked theory of freedom. Specifically, we compare Levinas’s account of freedom to the Kantian (and Fichtean) idea of freedom as autonomy and the Hegelian idea of freedom as relational. Based on these comparisons, we suggest that Levinas offers a distinctive conception of freedom—“finite freedom.” In contrast to Kantian autonomy, finite freedom constitutively involves (...) standing in certain social relations with others. And in contrast to Hegelian relational freedom, the social relations involved in finite freedom are not defined by mutual recognition, but by feelings of separation and even antagonism. Along the way, we promote a reading Levinas’s Totality and Infinity as a Hegel-style story of Bildung (development), and show how, on Levinas’s view, freedom can develop or mature in the life of the individual. (shrink)

Many differences exist between the logical relations “equality” and “equivalence”. In this monograph I point out differences that concern definition, linguistics, computational gates and tables, denotation, application, negation of terms, negation of the relation, relations to other relations, the laws of symmetry, transitivity and reflexivity, the laws of commutation and permutation, the law of tautology, the law of distribution, the law of association, propositional meaning, and “genesis”. I also point out a form of “symmetry breaking”: the negation of some equality (...) may yield some non-equality, while the negation of that non-equality might not yield the same equality. (For full access: use the website link of the title page. -- Copyright License: CC BY-NC-ND. -- DOI: 10.17026/dans-zh3-h2b2 --). (shrink)

Smart Farming Technologies raise ethical issues associated with the increased corporatization and industrialization of the agricultural sector. We explore the concept of biomimicry to conceptualize smart farming technologies as ecological innovations which are embedded in and in accordance with the natural environment. Such a biomimetic approach of smart farming technologies takes advantage of its potential to mitigate climate change, while at the same time avoiding the ethical issues related to the industrialization of the agricultural sector. We explore six principles of (...) a natural concept of biomimicry and apply these principles in the context of smart farming technologies. (shrink)

Some reasons are thought to depend on relations between people, such as that of a promiser to a promisee. It has sometimes been assumed that all reasons that are relational in this way are moral obligations. I argue, via a counter example, that there are non-obligatory relational reasons. If true, this has ramifications for relational theories of morality.

Being able to ask others to do things, and thereby giving them reasons to do those things, is a prominent feature of our interpersonal lives. In this paper, I discuss the distinctive normative status of requests – what makes them different from commands and demands. I argue for a theory of this normative phenomenon which explains the sense in which the reasons presented in requests are a matter of discretion. This discretionary quality, I argue, is something that other theories cannot (...) accommodate, though it is a significant aspect of the relations that people stand in to one another, and the kinds of practical reasons that flow from those relations. (shrink)

A lineage of prominent philosophers who have discussed the second-person relation can be regarded as advancing structural accounts. They posit that the second-person relation effects one transformative change to the structure of practical reasoning. In this paper, I criticise this orthodoxy and offer an alternative, substantive account. That is, I argue that entering into second-personal relations with others does indeed affect one's practical reasoning, but it does this not by altering the structure of one's agential thought, but by changing what (...) reasons can become available. The importance of second-personal thought for action is heterogenous. Second-person relations make possible the emergence of a wide variety of different kinds of practical reasons: creating some, revealing others. Recognising this diminishes the appeal of the traditional, structural accounts of the practical significance of such second-personal relations. Moving away from structural accounts facilitates a more thorough understanding of the intersubjective form of action. (shrink)

At the heart of Levinas’s work is the apparently simple idea that through the encounter with another person, we are forced to give up our self-concern and take heed of the ethical relation between us. But, while simple on the surface, when one tries to characterize it in more detail, it can be hard to fit together the various ways in which Levinas talks about this relation and to identify precisely what he took its normative structure to be, as this (...) is described in a number of apparently different ways, that are not obviously compatible or equivalent, such as “command,” “call,” “summons,” “demand,” and so on. In this chapter, we intend to focus on these different characterizations and show what makes them different while also endeavoring to find a way in which Levinas’s conception may nonetheless be fitted together into a coherent account of the face-to-face encounter that is at the heart of his ethics. We will begin by considering the different normative terms used to characterize the encounter in that text and show how they are conceptually distinct from one another; we will then offer a way to read Levinas’s position to nonetheless show how these different normative relations can be fitted together into a stable position. (shrink)

It is common for people to be sensitive to aesthetic qualities in one another’s speech. We allow the loveliness or unloveliness of a person’s voice to make impressions on us. What is more, it is also common to allow those aesthetic impressions to affect how we are inclined to feel about the speaker. We form attitudes of liking, trusting, disliking or distrusting partly in virtue of the aesthetic qualities of a person’s speech. In this paper I ask whether such attitudes (...) could ever be legitimate. This is a microcosm of the broader issue of whether people’s aesthetic qualities in general can justify the interpersonal valuing-attitudes that they so often cause. I draw from recent discussions of body aesthetics to articulate a pair of challenges. One challenge says that aesthetic judgements of speech are reliant on unjustifiable prejudices. The other holds that a person’s aesthetic qualities are irrelevant to whether they should be liked. Against these challenges I argue that some speech can bear aesthetic qualities which are not reliant on prejudice and which are relevant to whether the speaker should be liked. I develop this argument through an analysis of the concept of lyricism. (shrink)

Thе оutbrеаk оf thе соrоnаvirus disеаsе 2019 (СОVID-19) саusing milliоns оf pеоplе tо bе infесtеd hаs pоsеd mаjоr publiс hеаlth аnd gоvеrnаnсе сhаllеngеs. This study еvаluаtеs thе еxtеnt tо whiсh thе unаvаilаbility оf intеrnеt fоr сhildrеn tо lеаrn оnlinе during thе pаndеmiс аffесts pаrеntаl psyсhоlоgiсаl wеllbеing. Wе find thаt pаrеnts hаving nо intеrnеt fоr thеir сhildrеn tо lеаrn оnlinе during tо thе pаndеmiс аrе 40.37, 47.22, 43.68, аnd 46.90 pеrсеntаgе pоints mоrе likеly tо fееl аnxiоus, wоrriеd, displеаsеd, аnd dеprеssеd еvеry (...) dаy. Thе study саlls fоr thе еxpаnsiоn оf suppоrts fоr сhildrеn аnd fаmiliеs during thе pаndеmiс, еspесiаlly fоr disprоpоrtiоnаtеly аffесtеd соmmunitiеs. (shrink)

This paper examines how stances and understandings pertaining to whether home education is civically legitimate within liberal democratic contexts can depend on how one conceives normative roles of the secular state and the religious neutrality that is commonly associated with it. For the purposes of this paper, home education is understood as a manifestation of an educational philosophy ideologically based on a given conception of the good. -/- Two polar conceptions of secularism, republican and liberal-pluralist, are explored. Republican secularists declare (...) that religious expressions do not belong in the public sphere and justify this exclusion by promoting religious neutrality as an end in itself. But liberal-pluralists claim that religious neutrality is only the means to ensure protection of freedom of conscience and religion, which are moral principles. Each conception is associated with its own stance on whether exemptions or accommodations on account of religious beliefs have special legal standing and thereby warranted. The indeterminate nature of religion and the allegedly biased exclusion of secular beliefs, cited by some when denying religious exemptions, can be overcome by understanding all religious and conscientious beliefs as having equal standing as conceptions of the good. -/- Analysis of court documents from the Uwe Romeike et al asylum case are guided by these understandings, and relationships among themes are explored. -/- In summary, any stance regarding home education may depend on one’s view of secularism, particularly in relation to whether one views religious neutrality as a means to ensure protection of freedom of conscience or an end in itself. (shrink)

This chapter provides summaries of the chapter of this book and introduces the major themes and debates addressed in the volume. Discussed are Nietzsche’s metaphysics; his philosophy of mind in light of contemporary views; the question of panpsychism of Beyond Good and Evil 36; the rejection of dualism in favour of monism, in particular a monism of value; Nietzsche’s positions on consciousness and embodied cognition in light of recent cognitive science; a conception of freedom and agency based on an intrinsically (...) motivating; embodied sense of self-efficacy; a Nietzschean account of valuing understood as drive-induced affective orientations of which an agent approves; the idea of ressentiment conceived as a process of intentional, not reflectively strategic, self-deception about one’s own conscious mental states; and a defence of a Nietzschean naturalism. (shrink)

Amidst the lively and often highly positive reception of this best-selling collection of six essays in feminist philosophy, some critics have complained that it does not seem to argue for very much...

Résumé Si l’absence de moralité des psychopathes a été largement étudiée, il existe peu de recherches sur leurs capacités esthétiques. Pourtant, beaucoup d’études cliniques de cas montrent qu’ils présentent un grave déficit dans ce domaine. Cet article se propose d’en chercher les causes. Il analyse les forces et les limites de l’hypothèse d’un manque d’empathie pour expliquer ces carences esthétiques, et montre pourquoi l’hypothèse d’un manque de distance psychique se révèle plus féconde. Celle-ci permet en outre de comprendre le lien (...) de l’esthétique et de l’éthique par leur filiation commune : elles ont pour socle commun la capacité à prendre de la distance par rapport à des intérêts étroitement égoïstes. (shrink)

Een vrije en veerkrachtige samenleving ontstaat niet vanzelf en blijft niet vanzelf bestaan. In dit themanummer verkennen we de publieke onderwijstaak van het hoger beroepsonderwijs om studenten te onderwijzen de gemeenschappelijke wereld én het publieke gesprek over die wereld centraal te stellen. Met dit themanummer willen wij iets tegenover het vigerende marktdenken zetten. We laten ons hierbij inspireren door het gedachtegoed van Hannah Arendt (1906–1975). Ze heeft uitgebreid geschreven over ‘het publieke’. Ze verbindt de inzet van wetenschappelijke kennis en technologie (...) met het politieke vraagstuk: willen we daadwerkelijk leven in de wereld die we aan het scheppen zijn? Arendts gedachtegoed biedt volop handvatten om op verschillende niveaus van het hoger beroepsonderwijs deze taak te doordenken en invulling te geven. (shrink)

This volume presents new essays exploring important aspects of Nietzsche's philosophy in connection with two major themes: mind and nature. A team of leading experts address questions including: What is Nietzsche's conception of mind? How does mind relate with the nature? And what is Nietzsche's conception of nature? They all express the thought that Nietzsche's views on these matters are of great philosophical value, either because those views are consonant with contemporary thinking to a greater or lesser extent or because (...) they represent a rich alternative to contemporary attitudes. (shrink)

IPCC SPECIAL REPORT ON CLIMATE CHANGE AND LAND (SRCCL) -/- Chapter 3: Climate Change and Land: An IPCC special report on climate change, desertification, land degradation, sustainable land management, food security, and greenhouse gas fluxes in terrestrial ecosystems.

Transoral laser microsurgery applies to the piecemeal removal of malignant tumours of the upper aerodigestive tract using the CO2 laser under the operating microscope. This method of surgery is being increasingly popularised as a single modality treatment of choice in early laryngeal cancers (T1 and T2) and occasionally in the more advanced forms of the disease (T3 and T4), predomi- nantly within the supraglottis. Thomas Kuhn, the American physicist turned philosopher and historian of science, coined the phrase ‘paradigm shift’ in (...) his groundbreaking book The Structure of Scientific Revolutions. He argued that the arrival of the new and often incompatible idea forms the core of a new paradigm, the birth of an entirely new way of thinking. This article discusses whether Steiner and col- leagues truly brought about a paradigm shift in oncological surgery. By rejecting the principle of en block resection and by replacing it with the belief that not only is it oncologically safe to cut through the substance of the tumour but in doing so one can actually achieve better results, Steiner was able to truly revolutionise the man- agement of laryngeal cancer. Even though within this article the repercussions of his insight are limited to the upper aerodigestive tract oncological surgery, his willingness to question other peoples’ dogma makes his contribution truly a genuine paradigm shift. (shrink)

The integration of Internet Protocol and Embedded Systems can enhance the communication platform. This paper describes the emerging smart technologies based on Internet of Things (IOT) and internet protocols along with embedded systems for monitoring and controlling smart devices with the help of WiFi technology and web applications. The internet protocol (IP) address has been assigned to the things to control and operate the devices via remote network that facilitates the interoperability and end-to-end communication among various devices c,onnected over a (...) network. The HTTP POST and HTTP GET command that supports the RESTful service have been used to ensure the transmission and reception of packets between the IOT Gateway and Cloud Database. The emerging smart technologies based on the Internet of Things (IoT) facilitated features like automation, controllability, interconnectivity, reliability which in turn turn paved the way for a wide range of acceptance amongst the masses. The Internet of Things (IoT) has brought in many new emerging technologies into varoius field like our daily lives, industry, agricultural sector, and many more. The world is experiencing the explosive growth with the advent of Internet of Things (IoT) these years. The potential growth of IoT is enoromous which is evidenced by all the human beings in our day to day life. (shrink)

The aim of this paper is to provide a conceptual framework that will help in understanding and evaluating, along social and ethical lines, the issue of killing day-old male chicks and two alternative directions of responsible innovations to solve this issue. The following research questions are addressed: Why is the killing of day-old chicks morally problematic? Are the proposed alternatives morally sound? To what extent do the alternatives lead to responsible innovation? The conceptual framework demonstrates clearly that there is a (...) moral “lock-in”, and why the killing of day-old chicks is indeed an issue. Furthermore, it is shown that both alternative directions address some important objections with regard to the killing of day-old chicks, but that they also raise new dilemmas. It also becomes clear that the framework enables and secures anticipation, reflection, deliberation with and responsiveness to stakeholders, the four dimensions of responsible innovation, in a structured way. (shrink)

Objective: To examine the current ethical review process of ethics committees in a non-pharmacological trial from the perspective of a clinical investigator.Design: Prospective collection of data at the Study Centre of the German Surgical Society on the duration, costs and administrative effort of the ERP of a randomised controlled multicentre surgical INSECT Trial between November 2003 and May 2005.Setting: Germany.Participants: 18 ethics committees, including the ethics committee handling the primary approval, responsible overall for 32 clinical sites throughout Germany. 8 ethics (...) committees were located at university medical schools and 10 at medical chambers. Duration was measured as days between submission and receipt of final approval, costs in euros and administrative effort by calculation of the product of the total number of different types of documents and the mean number of copies required .Results: The duration of the ERP ranged from 1 to 176 days. The median duration was 26 days at MSUs compared with 34 days at medical chambers. The total cost was €2947. 1 of 8 ethics committees at universities and 8 of 10 at medical chambers charged a median fee of €162 . The administrative effort for primary approval was 30. Four ethics committees required a higher administrative effort for secondary approval .Conclusion: The ERP for non-pharmacological multicentre trials in Germany needs improvement. The administrative process has to be standardised: the application forms and the number and content of the documents required should be identical or at least similar. The fees charged vary considerably and are obviously too high for committees located at medical chambers. However, the duration of the ERP was, with some exceptions, excellent. A centralised ethics committee in Germany for multicentre trials such as the INSECT Trial can simplify the ERP for clinical investigators in and outside the country. (shrink)

Abstract: A novel quadric-dentate demi-macrocycle of the type [C14H30N2O2] (ClO4)2¯ was synthesized by 1:2 condensation reaction at high dilution process. The desired demi-macrocycle was characterized by spectral methods such as UV-visible, IR, 1HNMR and elemental analysis. The results obtained were in close conformity with properties and proposed structure.

Kripke (1977) views Donnellan's (1966) misdescription cases as cases where semantic reference and speaker's reference come apart. Such cases, however, are also cases where semantic reference conflicts with a distinct species of reference I call "public reference", i.e. the object that the cues publicly available at the time of utterance indicate is the speaker's referent of the utterance. This raises the question: do the misdescription cases trade on the distinction between semantic reference and speaker's reference, or the distinction between semantic (...) reference and public reference? I argue that Kripke's own construal in terms of semantic reference and speaker's reference is at best incomplete, and probably wrong. I also explain the general importance of the notion of 'public reference'. (shrink)

The results are interpreted in terms of a deficit in initial rule learning and subsequent generalization of these rules to new stimuli. Negative feedback is adequately processed at a neural level but this information is not used to improve behaviour on subsequent trials. As learning is degraded, the process of error detection at the moment of the actual response is diminished. Therefore, the current study demonstrates that disturbed error-monitoring processes play a central role in the often reported learning deficits in (...) individuals with PP. (shrink)

According to the cognitive model of psychopathology, maladaptive beliefs about oneself, others, and the world are the main factors contributing to the development and persistence of various forms of mental suffering. Therefore, the key therapeutic process of Cognitive Behavioral Therapy (CBT)—a therapeutic approach rooted in the cognitive model—is cognitive restructuring, i.e., a process of revision of such maladaptive beliefs. In this paper, I examine the philosophical assumptions underlying CBT and offer theoretical reasons to think that the effectiveness of belief revision (...) in psychotherapy is very limited. This is the case, I argue, because the cognitive model wrongly assumes that our body of beliefs is unified, while it is in fact fragmented. (shrink)

It is often suggested that we are equipped with a set of cognitive tools that help us to filter out unreliable testimony. But are these tools effective? I answer this question in two steps. Firstly, I argue that they are not real-time effective. The process of filtering, which takes place simultaneously with or right after language comprehension, does not prevent a particular hearer on a particular occasion from forming beliefs based on false testimony. Secondly, I argue that they are long-term (...) effective. Some hearers sometimes detect false testimony, which increases speakers’ incentives for honesty and stabilizes the practice of human communication in which deception is risky and costly. In short, filtering prevents us from forming a large number of beliefs based on false testimony, not by turning each of us into a high-functioning polygraph but by turning the social environment of human communication into one in which such polygraphs are not required. Finally, I argue that these considerations support strong anti-reductionism about testimonial entitlement. (shrink)

In their thought-provoking article, Sedlakova and Trachsel (2023) defend the view that the status—both epistemic and ethical—of Conversational Artificial Intelligence (CAI) used in psychotherapy is complicated. While therapeutic CAI seems to be more than a mere tool implementing particular therapeutic techniques, it falls short of being a “digital therapist.” One of the main arguments supporting the latter claim is that even though “the interaction with CAI happens in the course of conversation… the conversation is profoundly different from a conversation with (...) a human therapist” (Sedlakova and Trachsel 2023, 8). In particular, unlike a human therapist, CAI cannot help its users gain new insight and self-understanding (Sedlakova and Trachsel 2023). We agree that currently available therapeutic CAI cannot be considered a “digital therapist,” however, we think that the issue surrounding the acquisition of new self-understanding in the interaction with therapeutic CAI is more complicated than Sedlakova and Trachsel suggest. (shrink)

The majority of our linguistic exchanges, such as everyday conversations, are divided into turns; one party usually talks at a time, with only relatively rare occurrences of brief overlaps in which there are two simultaneous speakers. Moreover, conversational turn-taking tends to be very fast. We typically start producing our responses before the previous turn has finished, i.e., before we are confronted with the full content of our interlocutor’s utterance. This raises interesting questions about the nature of linguistic understanding. Philosophical theories (...) typically focus on linguistic understanding characterized either as an ability to grasp the contents of utterances in a given language or as outputs of this ability—mental states of one type or another. In this paper, I supplement these theories by developing an account of the process of understanding. I argue that it enables us to capture the dynamic and temporal aspect of understanding and reconcile philosophical investigations with empirical research on language comprehension. (shrink)

What justifies our beliefs about what other people say? According to epistemic inferentialism​, the justification of comprehension-based beliefs depends on the justification of other beliefs, e.g., beliefs about what words the speaker uttered or even what sounds they produced. According to epistemic non-inferentialism, the justification of comprehension-based beliefs ​does not depend on the justification of other beliefs. This paper offers a new defense of epistemic non-inferentialism. First, I discuss three counterexamples to epistemic non-inferentialism provided recently by Brendan Balcerak Jackson. I (...) argue that only one of Balcerak Jackson’s counterexamples is effective, and that it is effective against only one version of epistemic non-inferentialism, viz. language comprehension dogmatism. Second, I propose an alternative version of epistemic non-inferentialism, viz. comprehension-process reliabilism, which is immune to these counterexamples. I conclude that we should follow Balcerak Jackson in his rejection of language comprehension dogmatism but not all the way to the endorsement of epistemic inferentialism. Comprehension-process reliabilism is superior to both these alternatives. (shrink)

This article aims to read feminist new materialisms (Barad), together with ‘postulated’ linguistic or cultural primacy of Queer Theory (Butler), to show how both are engaged in similar critical-ethical endeavours. The central argument is that the criticism of Barad and new materialisms misses Butler’s materialistic insights due to a narrow interpretation of Butler's alleged social-constructivist position. There is, therefore, a specific focus on where they both make similar ethical appeals. Moreover, the article relies on Adorno's negative dialectic to highlight an (...) interpretation of Barad and Butler as being part of the same dialectical movement, in which materialism and idealism fluctuate in their mutual criticisms, thus continuing the procession towards 'new knowledge' and emancipation, or freedom, through their motions back and forth. (shrink)

Growing demand for broadly accessible mental health care, together with the rapid development of new technologies, trigger discussions about the feasibility of psychotherapeutic interventions based on interactions with Conversational Artificial Intelligence (CAI). Many authors argue that while currently available CAI can be a useful supplement for human-delivered psychotherapy, it is not yet capable of delivering fully fledged psychotherapy on its own. The goal of this paper is to investigate what are the most important obstacles on our way to developing CAI (...) systems capable of delivering psychotherapy in the future. To this end, we formulate and discuss three challenges central to this quest. Firstly, we might not be able to develop effective AI-based psychotherapy unless we deepen our understanding of what makes human-delivered psychotherapy effective. Secondly, assuming that it requires building a therapeutic relationship, it is not clear whether psychotherapy can be delivered by non-human agents. Thirdly, conducting psychotherapy might be a problem too complicated for narrow AI, i.e., AI proficient in dealing with only relatively simple and well-delineated tasks. If this is the case, we should not expect CAI to be capable of delivering fully-fledged psychotherapy until the so-called “general” or “human-like” AI is developed. While we believe that all these challenges can ultimately be overcome, we think that being mindful of them is crucial to ensure well-balanced and steady progress on our path to AI-based psychotherapy. (shrink)

There is a simple, intuitive theory of the semantic reference of proper names that has been unjustly neglected. This is the view that semantic reference is conventionalized speakers reference, i.e. the view that a name semantically refers to an object if, and only if, there exists a convention to use the name to speaker-refer to that object. The theory can be found in works dealing primarily with other issues (e.g. Stine in Philos Stud 33:319–337, 1977; Schiffer in Erkenntnis 13:171–206, 1978; (...) Sainsbury in Erkenntnis 80:195–214, 2015; Sainsbury, Thinking about things, Oxford University Press, 2018), yet these authors provide no sustained discussion of it. Devitt (Designation, Columbia University Press, 1981) did formulate a view on which semantic reference is conventionalized speaker’s reference, yet his views are assimilated to causalist views. This is a mistake. While the conventionalized speaker’s reference view captures much of what is plausible in descriptivism and causalism, it remains distinct from both. (shrink)

In the late 19th century, physiologists such as David Ferrier, Eduard Hitzig, and Hermann Munk argued that cerebral brain functions are localized in discrete structures. By the early 20th century, this became the dominant position. However, another prominent physiologist, Friedrich Goltz, rejected theories of cerebral localization and argued against these physiologists until his death in 1902. I argue in this paper that previous historical accounts have failed to comprehend why Goltz rejected cerebral localization. I show that Goltz adhered to a (...) falsificationist methodology, and I reconstruct how he designed his experiments and weighted different kinds of evidence. I then draw on the exploratory experimentation literature from recent philosophy of science to trace one root of the debate to differences in how the German localizers designed their experiments and reasoned about evidence. While Goltz designed his experiments to test hypotheses about the functions of predetermined cerebral structures, the localizers explored new functions and structures in the process of constructing new theories. I argue that the localizers relied on untested background conjectures to justify their inferences about functional organization. These background conjectures collapsed a distinction between phenomena they produced direct evidence for (localized symptoms) and what they reached conclusions about (localized functions). (shrink)

The goal of this paper is twofold. First, we argue that the understanding one has of a proposition or a propositional content of a representational vehicle is a species of what contemporary epistemologists characterise as objectual understanding. Second, we demonstrate that even though this type of understanding differs from linguistic understanding, in many instances of successful communication, these two types of understanding jointly contribute to understanding a communicated thought.