Von Zeit zu Zeit hat man Preisaufgaben uber die Frage gestellt, welche Fortschritte die Philosophie in einem bestimmten Zeitraume gemacht habe. Der Zeitabschnitt pflegte auf der einen Seite durch den Namen eines grosen Denkers, auf der andern durch die "Gegenwart"? abgegrenzt zu werden. Man schien also vorauszusetzen, das uber die philosophischen Fortschritte der Menschheit bis zu jenem Denker hin einigermasen Klarheit herrsche, das es aber von da ab zweifelhaft sei, welche neuen Errungenschaften die letzte Zeit hinzugefugt habe.

According to Rosenthal's higher-order thought (HOT) theory of consciousness, one is in a conscious mental state if and only if one is aware of oneself as being in that state via a suitable HOT. Several critics have argued that the possibility of so-called targetless HOTs—that is, HOTs that represent one as being in a state that does not exist—undermines the theory. Recently, Wilberg (2010) has argued that HOT theory can offer a straightforward account of such cases: since consciousness is a (...) property of mental state tokens, and since there are no states to exhibit consciousness, one is not in conscious states in virtue of targetless HOTs. In this paper, I argue that Wilberg's account is problematic and that Rosenthal's version of HOT theory, according to which a suitable HOT is both necessary and sufficient for consciousness, is to be preferred to Wilberg's account. I then argue that Rosenthal's account can comfortably accommodate targetless HOTs because consciousness is best understood as a property of individuals, not a property of states. (shrink)

Ichbin überzeugt, daß die Hauptwiderstände gegen unsere Auffassung daher rühren, daß der Unterschied zwischen der Falschheit und der Sinn|losigkeit eines Satzes nicht beachtet wird. Der Satz: ”Das Reden von einer metaphysischen Außenwelt ist sinnleer“ sagt nicht: ”Es gibt keine metaphysische Außenwelt“, sondern etwas toto coelo anderes. Der Empirist sagt dem Metaphysiker nicht: ”Deine Worte behaupten etwas Falsches“, sondern ”Deine Worte behaupten überhaupt nichts!“ Er widerspricht ihm nicht, sondern er sagt: ”Ich verstehe dich nicht“.

While there seems to be much evidence that perceptual states can occur without being conscious, some theorists recently express scepticism about unconscious perception. We explore here two kinds of such scepticism: Megan Peters and Hakwan Lau's experimental work regarding the well-known problem of the criterion -- which seems to show that many purported instances of unconscious perception go unreported but are weakly conscious -- and Ian Phillips' theoretical consideration, which he calls the 'problem of attribution' -- the worry that many (...) purported examples of unconscious perception are not perceptual, but rather merely informational and subpersonal. We argue that these concerns do not undermine the evidence for unconscious perception and that this sceptical approach results in a dilemma for the sceptic, who must either deny that there is unconscious mentality generally or explain why perceptual states are unique in the mind such that they cannot occur unconsciously. Both options, we argue, are problematic. (shrink)

According to what Birch (2022) calls the theory-heavy approach to investigating nonhuman-animal consciousness, we select one of the well-developed theories of consciousness currently debated within contemporary cognitive science and investigate whether animals exhibit the neural structures or cognitive abilities posited by that theory as sufficient for consciousness. Birch argues, however, that this approach is in general problematic because it faces what he dubs the dilemma of demandingness—roughly, that we cannot use theories that are based on the human case to assess (...) consciousness in nonhuman animals and vice versa. We argue here that, though this dilemma may problematize the application of many current accounts of consciousness to nonhuman animals, it does not challenge the use of standard versions of the higher-order thought theory (“HOTT”) of consciousness, according to which a creature is in a conscious mental state just in case it is aware of being in that state via a suitable higher-order thought (“HOT”). We show this in two ways. First, we argue that, unlike many extant theories of consciousness, HOTT is typically motivated by a commonsense, and more importantly, neutral condition on consciousness that applies to humans and animals alike. Second, we offer new empirical and theoretical reasons to think that many nonhuman animals possess the relevant HOTs necessary for consciousness. Considering these issues not only reveals the explanatory power of HOTT and some of its advantages over rival accounts, but also enables us to further extend and clarify the theory. (shrink)

I discuss here the nature of nonconscious mental states and the ways in which they may differ from their conscious counterparts. I first survey reasons to think that mental states can and often do occur without being conscious. Then, insofar as the nature of nonconscious mentality depends on how we understand the nature of consciousness, I review some of the major theories of consciousness and explore what restrictions they may place on the kinds of states that can occur nonconsciously. I (...) close with a discussion of what makes a state mental, if consciousness is not the mark of the mental. (shrink)

Many have claimed that epistemic rationality sometimes requires us to have imprecise credal states (i.e. credal states representable only by sets of credence functions) rather than precise ones (i.e. credal states representable by single credence functions). Some writers have recently argued that this claim conflicts with accuracy-centered epistemology, i.e., the project of justifying epistemic norms by appealing solely to the overall accuracy of the doxastic states they recommend. But these arguments are far from decisive. In this essay, we prove some (...) new results, which show that there is little hope for reconciling the rationality of credal imprecision with accuracy-centered epistemology. (shrink)

Relationalism holds that perceptual experiences are relations between subjects and perceived objects. But much evidence suggests that perceptual states can be unconscious. We argue here that unconscious perception raises difficulties for relationalism. Relationalists would seem to have three options. First, they may deny that there is unconscious perception or question whether we have sufficient evidence to posit it. Second, they may allow for unconscious perception but deny that the relationalist analysis applies to it. Third, they may offer a relationalist explanation (...) of unconscious perception. We argue that each of these strategies is questionable. (shrink)

It is often assumed that perceptual experience provides evidence about the external world. But much perception can occur unconsciously, as in cases of masked priming or blindsight. Does unconscious perception provide evidence as well? Many theorists maintain that it cannot, holding that perceptual experience provides evidence in virtue of its conscious character. Against such views, I challenge here both the necessity and, perhaps more controversially, the sufficiency of consciousness for perception to provide evidence about the external world. In addition to (...) motivating and defending the idea that unconscious perception can and does often provide evidence, I observe that whether or not perceptual phenomenology is relevant to the evidentiary status of perception depends on the nature of consciousness. And I argue that a well-supported theory of consciousness—higher-order thought theory—invites a striking conclusion: that perceptual phenomenology is not on its own sufficient to provide for evidence of the external world. (shrink)

I motivate and defend a previously underdeveloped functionalist account of the metaphysics of color, a view that I call ‘quality-space functionalism’ about color. Although other theorists have proposed varieties of color functionalism, this view differs from such accounts insofar as it identifies and individuates colors by their relative locations within a particular kind of so-called ‘quality space’ that reflects creatures’ capacities to discriminate visually among stimuli. My arguments for this view of color are abductive: I propose that quality-space functionalism best (...) captures our commonsense conception of color, fits with many experimental findings, coheres with the phenomenology of color experience, and avoids many issues for standard theories of color such as color physicalism and color relationalism. (shrink)

Problems in normative ethics paradigmatically concern what it is obligatory or permissible for an individual to do. Yet sometimes, each of us ought to do something individually in virtue of what we ought to do together. Unfortunately, traversing these two different levels at which a moral obligation can arise – individual and collective – is fraught with difficulties that easily lure us into conclusions muddying our understanding of collective obligations. This paper seeks to clearly lay out a systematic problem central (...) to the relation between collective and individual duties in view of alleviating some such confusion and facilitating more concerted attempts at resolving it: Collective duties require individuals to act in order for the collective duty to be fulfilled. Yet typically, a collective duty does not entail any one set of individual duties that would prescribe such contributory actions: The work we need to do in order to fulfil a duty can be allocated differently to the individuals collectively bearing it. Much like in matters of distributive justice, then, deriving individual duties from a collective one requires us to employ a distributive scheme, which raises separate normative concerns that have rarely taken centre stage in the debate so far. (shrink)

We argue that the need for commentary in commonly used linear calculi of natural deduction is connected to the “deletion” of illocutionary expressions that express the role of propositions as reasons, assumptions, or inferred propositions. We first analyze the formalization of an informal proof in some common calculi which do not formalize natural language illocutionary expressions, and show that in these calculi the formalizations of the example proof rely on commentary devices that have no counterpart in the original proof. We (...) then present a linear natural deduction calculus that makes use of formal illocutionary expressions in such a way that unique readability for derivations is guaranteed – thus showing that formalizing illocutionary expressions can eliminate the need for commentary. (shrink)

David Rosenthal explains conscious mentality in terms of two independent, though complementary, theories—the higher-order thought (“HOT”) theory of consciousness and quality-space theory (“QST”) about mental qualities. It is natural to understand this combination of views as constituting a kind of representationalism about experience—that is, a version of the view that an experience’s conscious character is identical with certain of its representational properties. At times, however, Rosenthal seems to resist this characterization of his view. We explore here whether and to what (...) extent it makes sense to construe Rosenthal’s views as representationalist. Our goal is not merely terminological—discerning how best to use the expression ‘representationalism’. Rather, we argue that understanding Rosenthal’s account as a kind of representationalism permits us not only to make sense of broader debates within the philosophy of mind, but also to extend and clarify aspects of the view itself. (shrink)

I offer here a new hypothesis about the nature of implicit attitudes. Psy- chologists and philosophers alike often distinguish implicit from explicit attitudes by maintaining that we are aware of the latter, but not aware of the former. Recent experimental evidence, however, seems to challenge this account. It would seem, for example, that participants are frequently quite adept at predicting their own perfor- mances on measures of implicit attitudes. I propose here that most theorists in this area have nonetheless overlooked (...) a commonsense distinction regarding how we can be aware of attitudes, a difference that fundamentally distinguishes implicit and explicit attitudes. Along the way, I discuss the implications that this distinction may hold for future debates about and experimental investigations into the nature of implicit attitudes. (shrink)

Perceptual experiences justify beliefs. A perceptual experience of a dog justifies the belief that there is a dog present. But there is much evidence that perceptual states can occur without being conscious, as in experiments involving masked priming. Do unconscious perceptual states provide justification as well? The answer depends on one’s theory of justification. While most varieties of externalism seem compatible with unconscious perceptual justification, several theories have recently afforded to consciousness a special role in perceptual justification. We argue that (...) such views face a dilemma: either consciousness should be understood in functionalist terms, in which case our best current theories of consciousness do not seem to imbue consciousness with any special epistemic features, or it should not, in which case it is mysterious why only conscious states are justificatory. We conclude that unconscious perceptual justification is quite plausible. (shrink)

This article provides a re-evaluation of David Hume's intensive reading of the classics at an important moment of his literary and intellectual career. It sets out to reconstruct the extent and depth of this reading as well as the uses – scholarly, philosophical and polemical – to which Hume put the information he had gathered in the course of it. The article contends that Hume read the classics against the grain to collect data on a wide range of cultural information (...) which he could utilise for a number of literary and philosophical projects he was engaged in during the early 1750s. This reading soon came to pervade almost all aspects of Hume's literary activities of that period and resulted in what is here described as a fragmentary history of classical antiquity. As a result Hume's reading of the classics emerges from this article as both more extensive and more significant than has so far been acknowledged. (shrink)

What is Understanding? This is the first of a series of Chats with OpenAI’s ChatGPT (Chat). The main goal is to obtain Chat’s response to a series of questions about the concept of ’understand- ing’. The approach is a conversational approach where the author (labeled as user) asks (prompts) Chat, obtains a response, and then uses the response to formulate followup questions. David Deutsch’s assertion of the primality of the process / capability of understanding is used as the starting point. (...) Understanding is posited as a major step in the Big Picture description of emergence in the Universe. Understanding follows the emergence of Brains and Minds, culminating in Power Over the Universe. My evaluation suggests that Chat does indeed offer utility, but also has limitations manifested by overly general responses that do not focus tightly on the questions asked. Chat does yield some gems that could be easily missed. The approach used here includes creating Metaprompts, wherein Chat is asked to create more efficient prompts based on initial promptsThis approach appears to hold significant promise, and will likely be of benefit to those exploring various facets of Artificial Intelligence (AI), Large Language Models (LLMs) and designers of Advanced General Intelligence (AGI). Other findings include the need for creating new metrics and ways of discussing intelligence, and various adjacent areas and subprocesses associated with intelligence. Discussions of future directions is also included. (shrink)

According to a traditional view, perceptual experiences are composites of distinct sensory and cognitive components. This dual-component theory has many benefits; in particular, it purports to offer a way forward in the debate over what kinds of properties perceptual experiences represent. On this kind of view, the issue reduces to the questions of what the sensory and cognitive components respectively represent. Here, I focus on the former topic. I propose a theory of the contents of the sensory aspects of perceptual (...) experience that provides clear criteria for identifying what kinds of properties they represent. (shrink)

The traditional use of the expression 'pseudoproblem' is analysed in order to clarify the talk of pseudoproblems and related phenomena. The goal is to produce a philosophically serviceable terminology that stays true to its historical roots. This explicative study is inspired by and makes use of the method of logical reconstruction. Since pseudoproblems are usually expressed by pseudoquestions a formal language of questions is presented as a possible reconstruction language for alleged pseudoproblems. The study yields an informal theory of pseudoproblems (...) whose presuppositions are critically investigated right away. At least one result remains: Claims of pseudoproblemship and their refutations must not be voiced casually - they are to be relativized and need substantial interpretive effort. (shrink)

Representationalism holds that a perceptual experience's qualitative character is identical with certain of its representational properties. To date, most representationalists endorse atomistic theories of perceptual content, according to which an experience's content, and thus character, does not depend on its relations to other experiences. David Rosenthal, by contrast, proposes a view that is naturally construed as a version of representationalism on which experiences’ relations to one another determine their contents and characters. I offer here a new defense of this holistic (...) representationalism, arguing that some objections to atomistic views are best interpreted as supporting it. (shrink)

The paper continues my earlier Chat with OpenAI’s ChatGPT with a Focused LLM Experiment (FLEX). The idea is to conduct Large Language Model (LLM) based explorations of certain areas or concepts. The approach is based on crafting initial guiding prompts and then follow up with user prompts based on the LLMs’ responses. The goals include improving understanding of LLM capabilities and their limitations culminating in optimized prompts. The specific subjects explored as research subject matter include a) diagonalization techniques as practiced (...) by Cantor, Turing, Gödel, and the advances, such as the Forcing techniques introduced by Paul Cohen and later investigators, b) Knowledge Hierarchies & Mapping Exercises, c) Discussions of IJ Good’s Speculations Concerning the First Ultraintelligent Machine, AGI, and Super- intelligence. Results suggest variability between major models like ChatGPT-4, Llama-3, Cohere, Sonnet and Opus. Results also point to strong dependence on users’ preexisting knowledge and skill bases. The paper should be viewed as ’raw data’ rather than a polished authoritative reference. (shrink)

Consciousness is central to our lived experience. It is unsurprising, then, that the topic has captivated many students, neuroscientists, philosophers, and other theorists working in cognitive science. But consciousness may seem especially difficult to explain. This is in part because the term “consciousness” has been used in many different ways. The goal of this chapter is to explore several kinds of consciousness: what theorists have called “creature,” “phenomenal,” “access,” “state,” “transitive,” “introspective,” and “self” consciousness. The basic distinctions among these kinds (...) of consciousness are described in Section 1. Section 2 raises potential challenges for explaining these varieties of consciousness and describes a few current theories of them. Section 3 closes the chapter by exploring directions for future work in the cognitive science of consciousness. Along the way, some of the possible interrelationships among these kinds of consciousness are discussed. (shrink)

In his paper “There It Is” and his précis “There It Was,” Benj Hellie develops a sophisticated semantics for perceptual justification according to which perceptions in good cases can be explained by intentional psychology and can justify beliefs, whereas bad cases of perception are defective and so cannot justify beliefs. Importantly, Hellie also affords consciousness a central role in rationality insofar as only those good cases of perception within consciousness can play a justificatory function. In this commentary, I reserve judgment (...) regarding Hellie’s treatment of the rational difference between good and bad cases, but I argue there can be what he views as good cases of perceptual justification outside of consciousness. (shrink)

One of the most promising theories of consciousness currently available is higher-order thought (“HOT”) theory, according to which consciousness consists in having suitable HOTs regarding one’s mental life. But critiques of HOT theory abound. We explore here three recent objections to the theory, which we argue at bottom founder for the same reason. While many theorists today assume that consciousness is a feature of the actually existing mental states in virtue of which one has experiences, this assumption is in tension (...) with the underlying motivations for HOT theory and arguably false. We urge that these objections, though sophisticated, trade on this questionable conception of consciousness, thereby begging the question against HOT theory. We then explain how HOT theory might instead understand consciousness. (shrink)

Virtue-based moral cognitivism holds that at least some of the value of some art consists in conveying knowledge about the nature of virtue and vice. We explore here a challenge to this view, which extends the so-called situationist challenge to virtue ethics. Evidence from social psychology indicates that individuals’ behavior is often susceptible to trivial and normatively irrelevant situational influences. This evidence not only challenges approaches to ethics that emphasize the role of virtue but also undermines versions of moral cognitivism, (...) because the value of art cannot consist in teaching us about traits that do not exist. We thus recommend a new account of the cognitive value of art: art teaches how context and character interact to produce action. (shrink)

Mandik (2012)understands color-consciousness conceptualism to be the view that one deploys in a conscious qualitative state concepts for every color consciously discriminated by that state. Some argue that the experimental evidence that we can consciously discriminate barely distinct hues that are presented together but cannot do so when those hues are presented in short succession suggests that we can consciously discriminate colors that we do not conceptualize. Mandik maintains, however, that this evidence is consistent with our deploying a variety of (...) nondemonstrative concepts for those colors and so does not pose a threat to conceptualism. But even if Mandik has shown that we deploy such concepts in these experimental conditions, there are cases of conscious states that discriminate colors but do not involve concepts of those colors. Mandik’s arguments sustain only a theory in the vicinity of conceptualism: The view that we possess concepts for every color we can discriminate consciously, but need not deploy those concepts in every conscious act of color discrimination. (shrink)

Building on the work of Peter Hinst and Geo Siegwart, we develop a pragmatised natural deduction calculus, i.e. a natural deduction calculus that incorporates illocutionary operators at the formal level, and prove its adequacy. In contrast to other linear calculi of natural deduction, derivations in this calculus are sequences of object-language sentences which do not require graphical or other means of commentary in order to keep track of assumptions or to indicate subproofs. (Translation of our German paper "Ein Redehandlungskalkül. Ein (...) pragmatisierter Kalkül des natürlichen Schließens nebst Metatheorie"; online available at http://philpapers.org/rec/CORERE.). (shrink)

Many theorists maintain that perceptual experience exhibits the what is often called the phenomenology of particularity: that in perceptual experience it phenomenally seems that there are particular things. Some urge that this phenomenology demands special accounts of perception on which particulars somehow constitute perceptual experience, including versions of relationalism, on which perception is a relation between perceivers and particular perceived objects, or complex forms of representationalism, on which perception exhibits demonstrative or special particular-involving types of content. I argue here that (...) no such account required. I develop and defend a novel account of such phenomenology, grounded in the higher-order theory of consciousness. In short, this view holds that the phenomenology of particularity arises because suitable higher-order states make it appear to one that one is in perceptual relations to particulars, even if perception is not in any way constituted by particulars. I argue that this account has many advantages and avoids problems that other theories of such phenomenology face. (shrink)

This essay reconsiders David Hume’s thinking on the fate of the British Empire and the future of established religion. It provides a detailed reconstruction of the development of Hume’s views on Britain’s successive attempts to impose or regain its authority over its North American colonies and compares these views with the stance taken during the American Crisis by Adam Smith and Josiah Tucker. Fresh light is shed on this area of Hume’s later political thought by a new letter, appended to (...) the essay, which at the same time provides an illuminating glimpse of his abiding preoccupation with the future of established religion. It is argued that this evidence of Hume’s privately held views belies the notion that his thinking on political and religious matters was fundamentally opposed to that of his friends among the philosophes. It is consequently misleading to regard Hume as an opponent of the more radical wing of the Enlightenment. (shrink)

While epistemic democrats have claimed that majority rule recruits the wisdom of the crowd to identify correct answers to political problems, the conjecture remains abstract. This article illustrates how majority rule leverages the epistemic capacity of the electorate to practically enhance the instrumental value of elections. To do so, we identify a set of sufficient conditions that effect such a majority rule mechanism, even when the decision in question is multidimensional. We then look to the case of sociotropic economic voting (...) in US presidential elections to provide empirical tractability for these conditions. We find that absent such an epistemic capacity a number of presidential elections might well have been decided differently. By generating clear conditions for the plausibility of claims made by epistemic democrats, and demonstrating their correspondence to empirical data, this article strengthens the broader instrumental grounds recommending democracy. (shrink)

The problem of diachronic personal identity is this: what explains why a person P1 at time T1 is numerically identical with a person P2 at a later time T2, even if they are not at those times qualitatively identical? One traditional explanation is the soul theory, according to which persons persist in virtue of their nonphysical souls. I argue here that this view faces a new and arguably insuperable dilemma: either souls, like physical bodies, change over time, in which case (...) the soul theory faces an analogue problem of diachronic soul identity, or souls, unlike physical bodies, do not change over time, in which case the soul theory cannot explain why souls relate to particular bodies over time and so at best only partially explains personal identity. I conclude that the soul theory fares no better than physicalist-friendly accounts of personal identity such as bodily- or psychological-continuity-based views. (shrink)

According to David Rosenthal’s higher-order thought (HOT) theory of consciousness, a mental state is conscious just in case one is aware of being in that state via a suitable HOT. Jesse Mulder (2016) recently objects: though HOT theory holds that conscious states are states that it seems to one that one is in, the view seems unable to explain how HOTs engender such seemings. I clarify here how HOT theory can adequately explain the relevant mental appearances, illustrating the explanatory power (...) of HOT theory. (shrink)

Climate change, pollution, and deforestation have a negative impact on global mental health. There is an environmental justice dimension to this challenge as wealthy people and high-income countries are major contributors to climate change and pollution, while poor people and low-income countries are heavily affected by the consequences. Using state-of-the art data mining, we analyzed and visualized the global research landscape on mental health, climate change, pollution and deforestation over a 15-year period. Metadata of papers were exported from PubMed®, and (...) both relevance and relatedness of terms in different time frames were computed using VOSviewer. Co-occurrence graphs were used to visualize results. The development of exemplary terms over time was plotted separately. The number of research papers on mental health and environmental challenges is growing in a linear fashion. Major topics are climate change, chemical pollution, including psychiatric medication in wastewater, and neurobiological effects. Research on specific psychiatric syndromes and diseases, particularly on their ethical and social aspects is less prominent. There is a growing body of research literature on links between mental health, climate change, pollution, and deforestation. This research provides a graphic overview to mental healthcare professionals and political stakeholders. Social and ethical aspects of the climate change-mental health link have been neglected, and more research is needed. (shrink)

Memetic Science is the name of a new field that deals with the quantitativeanalysis of cultural transfer.The units of cultural transfer are entities called "memes". In a nutshell, memes are to cultural and mental constructs as genesare to biological organisms. Examplesof memesare ideas,tunes, fashions, and virtuallyany culturaland behavioral unit that gets copiedwitha certaindegree of fidelity. It is arguedthat the under standing of memes is of similar importance and consequence as the understanding of processes involving DNA and RNA in molecular biology.Thispaperpresentsa (...) rigorousfoundation fordiscussion ofmemes and approaches to quantifying relevantaspects of memegenesis, inter action, mutation, growth,deathand spreadingprocesses. It is also argued inthispaper that recombinant memetics is possible incomplete analogy to recombinant DNA/ genetic engineering. Special attention is paid to memes in written modern English. (shrink)

How to participate proactively in a process of change and transformation, to shape our path within an uncertain future? With this publication, the State Of The Art Network marks a waypost on a journey which started in 2018, when like-minded Nordic and Baltic art organisations and professionals initiated this network as a multidisciplinary collaboration facing the Anthropocene. Over five years, ten organisations and around 80 practitioners from different disciplines, like the arts, natural sciences and humanities came together, online and in (...) person, for workshops, seminars and discussions. The aim was to find ways to create resilience and concrete actions on how to live through the change in culture, economy and the environment and to find concrete, hands-on methods to deal with the Anthropocene and the environmental crisis. As an outcome of this process, this publication takes a closer look at how we as practising artists, researchers and cultural actors can create elements for critical thinking and doing which can assist us in navigating the complexities of the present. -/- Edited for the State Of The Art Network by Erich Berger, Mari Keski-Korsu, Marietta Radomska and Line Thastum. -/- Produced and published by Bioart Society 2023. (shrink)

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.

BACKGROUND: Little is known about how hospitalized patients share decisions with physicians. METHODS: We conducted an observational study of patient-doctor communication on an inpatient medicine service among 18 hospitalized patients and 9 physicians. A research assistant (RA) approached newly hospitalized patients and their physicians before morning rounds and obtained consent. The RA audio recorded morning rounds, and then separately interviewed both patient and physician. Coding was done using integrated analysis. RESULTS: Most patients were white (61%) and half were female. Most (...) physicians were male (66%) and of Southeast Asian descent (66%). All physicians explained the plan of care to the patients; most believed that their patient understood. However, many patients did not. Physicians rarely asked the patient for their opinion. In all those cases, the decision had been made previously by the doctors. No decisions were made with the patient. Patients sometimes disagreed. CONCLUSIONS: Shared decision-making may not be the norm in hospital care. Although physicians do explain treatment plans, many hospitalized patients do not understand enough to share in decisions. When patients do assert their opinion, it can result in conflict. PRACTICE IMPLICATIONS: Some hospitalized patients are interested in discussing treatment. Improving hospital communication can foster patient autonomy. (shrink)

Some theorists have recently raised doubts about much of the experimental evidence purporting to demonstrate the existence of unconscious perception. In our (2019) in this journal, we argued some of these considerations are not decisive. Phillips (forthcoming a) replies thoughtfully to our paper, concluding that he is unconvinced by our arguments. Phillips maintains that the view that perception is invariably conscious remains, as he puts it, the “default” hypothesis both within the folk understanding and experimental study of perception. There is (...) much to agree with in Phillips’ piece, but there remain some substantive points of disagreement, which we outline here. (shrink)

It is popular to hold that emotions are evaluative. On the standard account, the evaluative character of emotion is understood in epistemic terms: emotions apprehend or make us aware of value properties. As this account is commonly elaborated, emotions are experiences with evaluative intentional content. In this paper, I am concerned with a recent alternative proposal on how emotions afford awareness of value. This proposal does not ascribe evaluative content to emotions, but instead conceives of them as evaluative at the (...) level of intentional mode or attitude. I first argue that this proposal fails to make emotions intelligible as value apprehensions. There are reasons to suppose that emotions do not apprehend value to begin with, but are related to values in a different, non-epistemic sense. I then go on to show that the notion of an evaluative intentional mode can still help elucidate the evaluative character of emotion. I argue that there is a plausible non-epistemic understanding of the view that emotions are evaluative modes. On this account, emotions are not ways of apprehending values, but ways of acknowledging values. (shrink)

The UN Convention against Torture defines torture as “any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person” by someone acting in an official capacity for purposes such as obtaining a confession or punishing or intimidating that person.1 It is unethical for healthcare professionals to participate in torture, including any use of medical knowledge or skill to facilitate torture or allow it to continue, or to be present during torture.2-7 Yet medical participation (...) in torture has taken place throughout the world and was a prominent feature of the US interrogation practice in military and Central Intelligence Agency (CIA) detention facilities in the years after the attacks of 11 September 2001.8-11 Little attention has been paid, however, to how a regime of torture affects the ability of health professionals to meet their obligations regarding routine clinical care for detainees. -/- The 2016 release of previously classified portions of guideline from the CIA regarding medical practice in its secret detention facilities sheds light on that question. These show that the CIA instructed healthcare professions to subordinate their fundamental ethical obligations regarding professional standards of care to further the objectives of the torturers. (shrink)

An estimated 700,000 people in the United States have "long COVID," that is, symptoms of COVID-19 persisting beyond three weeks. COVID-19 and its long-term sequelae are strongly influenced by social determinants such as poverty and by structural inequalities such as racism and discrimination. Primary care providers are in a unique position to provide and coordinate care for vulnerable patients with long COVID. Policy measures should include strengthening primary care, optimizing data quality, and addressing the multiple nested domains of inequity.

A fun piece discussing the challenges to and prospects of building machines that are able to produce and understand natural language.

One of the best-known principles of halakha is that Shabbat is violated to save a life. Who does this saving and how do we know that a life is in danger? What categories of illness violate Shabbat and who decides? A historical-sociological analysis of the roles played by Jew, non-Jew, and physician according to the approach of “medical cosmology” can help us understand the differences in the approach of the Shulchan Aruch compared to later decisors (e.g., the Mishnah Berurah). Such (...) differences illuminate how premodern medical triage coexisted with a different halakhic understanding than that of the biomedical age. (shrink)

It is a popular thought that emotions play an important epistemic role. Thus, a considerable number of philosophers find it compelling to suppose that emotions apprehend the value of objects and events in our surroundings. I refer to this view as the Epistemic View of emotion. In this paper, my concern is with a rivaling picture of emotion, which has so far received much less attention. On this account, emotions do not constitute a form of epistemic access to specific axiological (...) aspects of their objects. Instead it proposes that they are ways of taking a stand or position on the world. I refer to this as the Position-Taking View of emotion. Whilst some authors seem sympathetic to this view, this it has so far not been systematically motivated and elaborated. In this paper, I fill this gap and propose a more adequate account of our emotional engagement with the world than the predominant epistemic paradigm. I start by highlighting the specific way in which emotions are directed at something, which I contrast with the intentionality of perception and other forms of apprehension. I then go on to offer a specific account of the valence of emotion and show how this account and the directedness of emotions makes them intelligible as a way of taking a position on something. (shrink)

A prominent version of emotional cognitivism is the view that emotions are preceded by awareness of value. In a recent paper, Jonathan Mitchell (2019) has attacked this view (which he calls the content-priority view). According to him, extant suggestions for the relevant type of pre-emotional evaluative awareness are all problematic. Unless these problems can be overcome, he argues, the view does not represent a plausible competitor to rivaling cognitivist views. As Mitchell supposes, the view is not mandatory since its core (...) motivations can be accommodated by competing views, too. I argue that Mitchell's case against the content-priority view is unconvincing as it misconceives the principal motivation for the view. As I show, properly reconstructed, this motivation provides a strong case for the indispensability of the view to any adequate cognitivist treatment of emotion. Moreover, Mitchell's survey of candidates for pre-emotional value awareness can be seen to rest on problematic phenomenological assumptions. (shrink)

In contemporary bioethics, the autonomy of the patient has assumed considerable importance. Progressing from a more limited notion of informed consent, shared decision making calls upon patients to voice the desires and preferences of their authentic self, engaging in choice among alternatives as a way to exercise deeply held values. One influential opinion in Jewish bioethics holds that Jewish law, in contradistinction to secular bioethics, limits the patient's exercise of autonomy only in those instances in which treatment choices are sensitive (...) to preferences. Here, we analyze a discussion in the Mishna, a foundational text of rabbinic Judaism, regarding patient autonomy in the setting of religiously mandated fasting, and commentaries in the Babylonian and Palestinian Talmuds, finding both a more expansive notion of such autonomy and a potential metaphysical grounding for it in the importance of patient self-knowledge. (shrink)