In an effort to construct a plausible theory of experience-based welfare, Wayne Sumner imposes two requirements on the relevant kind of experience: the information requirement and the autonomy requirement. I argue that both requirements are problematic.First, I argue (very briefly) that a well-know case like ‘the deceived businessman’ need not support the information requirement as Sumner believes. Second, I introduce a case designed to cast further doubt on the information requirement. Third, I attend to a shortcoming in Sumner’s theory (...) of welfare, namely that it is unclear which of later and informed assessments are to be treated as authoritative when it comes to the evaluation of a person’s welfare. Finally, I suggest that, in combination with ‘welfarism’ (to which Sumner subscribes, and which has it that welfare is all that matters from a moral viewpoint), the information requirement entail morally troublesome conclusions: e.g. the conclusion that, from a moral point of view, we should, other things being equal, only to be concerned with the alternative that makes one person slightly better off in respect of welfare instead of also being morally concerned with the alternative that makes one person very happy. (shrink)

The nature of the cognition-motor interface has been brought to prominence by Butterfill & Sinigaglia, who argue that the representations employed by the cognitive and motor systems should not be able to interact with each other. Here I argue that recent empirical evidence concerning the interface contradicts several of the assumptions incorporated in Butterfill & Sinigaglia’s account, and I seek to develop a theoretical picture that will allow us to explain the structure of the interface presented by this evidence. The (...) central idea is that neural plasticity incorporates metarepresentational rules for constructing representational systems and linking them. The structure of the cognition-motor interface is constructed flexibly during development and skill learning based on information processing demands. (shrink)

This essay argues that current theories of action fail to explain agentive control because they have left out a psychological capacity central to control: attention. This makes it impossible to give a complete account of the mental antecedents that generate action. By investigating attention, and in particular the intention-attention nexus, we can characterize the functional role of intention in an illuminating way, explicate agentive control so that we have a uniform explanation of basic cases of causal deviance in action as (...) well as other defects of agency, explain cases of skilled agency and sharpen questions about the role of thought in agency. This provides for a different orientation in the theory of action. (shrink)

Attention has become an important focal point of recent work in ethics and epistemology, yet philosophers continue to be noncommittal about what attention is. In this paper, I defend attention as selection for action in a weak form, namely that selection for action is sufficient for attention. I show that selection for action in this form is part of how we, the folk, experience it and how the cognitive scientist studies it. That is, selection for action pulls empirical and folk-psychology (...) together. Accordingly, philosophers who take seriously either source have reason to work with selection for action as their starting conception of attention. This conception provides a way to bridge empirical and philosophical concerns where attention is central. The theoretical advantages of selection for action have been obscured by the common opinion that it is easily refuted. I defend the position against many of the published objections and then deploy it to provide a foundation for the intuitive, but inchoate idea of attention being more or less, focusing on recent work in the ethics of attention. (shrink)

In this paper, I argue that visual attention is cognitively penetrated by intention. I present a detailed account of attention and its neural basis, drawing on a recent computational model of neural modulation during attention: divisive normalization. I argue that intention shifts computations during divisive normalization. The epistemic consequences of attentional bias are discussed.

In Movements of the Mind (MoM; Wu, 2023a), I give a theory of agency that uncovers its internal psychological structure, revealing how creatures with minds do things. While my focus is on things we do 'in our heads', mental actions, the theory concerns all forms of agency. The book also provides a theory of attention and its essential connection to action. It characterizes intention in action as a type of memory for work, drawing on empirical theories of working memory. Further, (...) it reveals the essential role of bias in action, providing an account of various psychological biases. The theory is then applied to three phenomena prominent in philosophical practice: implicit (better, automatic) bias, reasoning deductively, and introspection of conscious perceptual experience. (shrink)

Tasks, tools, and techniques that we perform, use, and acquire, define the elements of expertise which we value as the hallmarks of goal-driven behavior. Somehow, the creation of tools enables us to define new tasks, or is it that the envisioning of new tasks drives us to invent new tools? Or maybe it is that new tools engender new techniques which then result in new tasks? This jumble of issues will be explored and discussed in this diverse collection of papers. (...) Individually, few of the papers are related to each other by topic or by techniques of analysis. Collectively, all focus on tasks performed using tools and discuss the techniques of tool use which enable differences in performance and expertise across individuals, societies, and (even) species. -/- . (shrink)

Milner and Goodale's influential account of the primate cortical visual streams involves a division of consciousness between them, for it is the ventral stream that has the responsibility for visual consciousness. Hence, the dorsal visual stream is a ‘zombie’ stream. In this article, I argue that certain information carried by the dorsal stream likely plays a central role in the egocentric spatial content of experience, especially the experience of visual spatial constancy. Thus, the dorsal stream contributes to a pervasive feature (...) of consciousness. (shrink)

This chapter will review selected aspects of the terrain of discussions about probabilities in statistical mechanics (with no pretensions to exhaustiveness, though the major issues will be touched upon), and will argue for a number of claims. None of the claims to be defended is entirely original, but all deserve emphasis. The first, and least controversial, is that probabilistic notions are needed to make sense of statistical mechanics. The reason for this is the same reason that convinced Maxwell, Gibbs, and (...) Boltzmann that probabilities would be needed, namely, that the second law of thermodynamics, which in its original formulation says that certain processes are impossible, must, on the kinetic theory, be replaced by a weaker formulation according to which what the original version deems impossible is merely improbable. Second is that we ought not take the standard measures invoked in equilibrium statistical mechanics as giving, in any sense, the correct probabilities about microstates of the system. We can settle for a much weaker claim: that the probabilities for outcomes of experiments yielded by the standard distributions are effectively the same as those yielded by any distribution that we should take as a representing probabilities over microstates. Lastly, (and most controversially): in asking about the status of probabilities in statistical mechanics, the familiar dichotomy between epistemic probabilities (credences, or degrees of belief) and ontic (physical) probabilities is insufficient; the concept of probability that is best suited to the needs of statistical mechanics is one that combines epistemic and physical considerations. (shrink)

Much work on the sense of agency has focused either on abnormal cases, such as delusions of control, or on simple action tasks in the laboratory. Few studies address the nature of the sense of agency in complex natural settings, or the effect of skill on the sense of agency. Working from 2 case studies of mountain bike riding, we argue that the sense of agency in high-skill individuals incorporates awareness of multiple causal influences on action outcomes. This allows fine-grained (...) differentiation of the contributions of self and external factors to action outcomes. We further argue that the sense of agency incorporates prospective awareness of actions that are possible in a situation and awareness of the limits of control. These forms of sense of agency enable highly flexible, context-sensitive strategic control, and are likely to contribute to high interindividual variability in responses to complex tasks. (shrink)

This paper considers the connection between automaticity, control and agency. Indeed, recent philosophical and psychological works play up the incompatibility of automaticity and agency. Specifically, there is a threat of automaticity, for automaticity eliminates agency. Such conclusions stem from a tension between two thoughts: that automaticity pervades agency and yet automaticity rules out control. I provide an analysis of the notions of automaticity and control that maintains a simple connection: automaticity entails the absence of control. An appropriate analysis, however, shows (...) that actions are forms of control and pervasively automatic even if automaticity implies the absence of control. Consequences are drawn for the theory of mental agency and the psychological concepts of automaticity and control. (shrink)

This chapter discusses the importance of developing an explicitly metaphysical approach to the study of terrorism. Taking its cue from John Carroll’s Break-Out from the Crystal Palace and Terror: A Meditation on the Meaning of September 11, the chapter sheds light on the character of the “terrorist persona” as a means of understanding how individuals become capable of perpetrating crimes of horrific and indiscriminate violence. Identifying a persona that seeks self-realisation through violent overthrow of alienating moral and political institutions, the (...) chapter identifies a specific kind of terrorism that finds its origins in a misreading of Max Stirner and Friedrich Nietzsche. (shrink)

The most contentious tenet of Husserl's phenomenology of feelings is his conclusion that there is an analogy between axiological reason and theoretical reason. Simply, Husserl asserts that the axiological validation of feelings is analogical to the theoretical validation of judgments. While the scholarship has debated the merits of Husserl's analogy over the last 120 years, this paper presents a new accurate interpretation, because it is the first to highlight how Husserl develops this analogy by most often comparing the fulfillment of (...) judgments to the fulfillment of wish feeling intentions. Specifically, I examine how Husserl analogizes wish fulfillment to theoretical fulfillment at different times; in the 1901 Logical Investigations, in his 1908 Lectures on Ethics, and in 1910 manuscripts from Studien zur Struktur des Bewusstseins. In light of this original interpretation, I conclude by arguing – contra popular readings – that Husserl does not over‐intellectualize feelings and their validation. (shrink)

We investigate flexibility and problem solving in skilled action. We conducted a field study of mountain bike riding that required a learner rider to cope with major changes in technique and equipment. Our results indicate that relatively inexperienced individuals can be capable of fairly complex 'on-the-fly' problem solving which allows them to cope with new conditions. This problem solving is hard to explain for classical theories of skill because the adjustments are too large to be achieved by automatic mechanisms and (...) too complex and rapid to be achieved by cognitive processes as they are usually understood. A recent theory, Mesh, can explain these results because it posits that skill-specific cognitive abilities develop during skill learning and that control typically involves an interplay between cognitive and automatic mechanisms. Here we develop Mesh further, providing a detailed explanation for these problem solving abilities. We argue that causal representation, metacognitive awareness and other forms of performance awareness combine in the formulation and control of action strategies. We also argue that the structure of control present in this case is inconsistent with Bratman's model of intentions, and that, in the face of high uncertainty and risk, intentions can be much more labile than Bratman recognises. In addition, we found limitations and flaws in problem solving which illuminate the representations involved. Finally, we highlight the crucial role of social and cultural learning in the development of complex skills. (shrink)

One finds, in Maxwell's writings on thermodynamics and statistical physics, a conception of the nature of these subjects that differs in interesting ways from the way that they are usually conceived. In particular, though—in agreement with the currently accepted view—Maxwell maintains that the second law of thermodynamics, as originally conceived, cannot be strictly true, the replacement he proposes is different from the version accepted by most physicists today. The modification of the second law accepted by most physicists is a probabilistic (...) one: although statistical fluctuations will result in occasional spontaneous differences in temperature or pressure, there is no way to predictably and reliably harness these to produce large violations of the original version of the second law. Maxwell advocates a version of the second law that is strictly weaker; the validity of even this probabilistic version is of limited scope, limited to situations in which we are dealing with large numbers of molecules en masse and have no ability to manipulate individual molecules. Connected with this is his concept of the thermodynamic concepts of heat, work, and entropy; on the Maxwellian view, these are concepts that must be relativized to the means we have available for gathering information about and manipulating physical systems. The Maxwellian view is one that deserves serious consideration in discussions of the foundation of statistical mechanics. It has relevance for the project of recovering thermodynamics from statistical mechanics because, in such a project, it matters which version of the second law we are trying to recover. (shrink)

In response to Mole 2009, I present an argument for zombie action. The crucial question is not whether but rather to what extent we are zombie agents. I argue that current evidence supports only minimal zombie agency.

Empirical work and philosophical analysis have led to widespread acceptance that vision for action, served by the cortical dorsal stream, is unconscious. I argue that the empirical argument for this claim is unsound. That argument relies on subjects’ introspective reports. Yet on biological grounds, in light of the theory of primate cortical vision, introspection has no access to dorsal stream mediated visual states. It is thus wrongly assumed that introspective reports speak to absent phenomenology in the dorsal stream. In light (...) of this, I consider a different conception of consciousness’s relation to agency in terms of access. While theoretical reasons suggest that the inaccessibility of the dorsal stream to conceptual report is evidence that it is unconscious, this position begs important questions. I propose a broader notion of access in respect of the guidance of intentional agency and not, narrowly, conceptual report (Note: this paper contradicts my earlier paper, "The Case for Zombie Agency"). (shrink)

Do self‐monitoring accounts, a dominant account of the positive symptoms of schizophrenia, explain auditory verbal hallucination? In this essay, I argue that the account fails to answer crucial questions any explanation of auditory verbal hallucination must address. Where the account provides a plausible answer, I make the case for an alternative explanation: auditory verbal hallucination is not the result of a failed control mechanism, namely failed self‐monitoring, but, rather, of the persistent automaticity of auditory experience of a voice. My argument (...) emphasizes the importance of careful examination of phenomenology as providing substantive constraints on causal models of the positive symptoms in schizophrenia. (shrink)

This document presents the Bonn PRINTEGER Consensus Statement: Working with Research Integrity—Guidance for research performing organisations. The aim of the statement is to complement existing instruments by focusing specifically on institutional responsibilities for strengthening integrity. It takes into account the daily challenges and organisational contexts of most researchers. The statement intends to make research integrity challenges recognisable from the work-floor perspective, providing concrete advice on organisational measures to strengthen integrity. The statement, which was concluded February 7th 2018, provides guidance on (...) the following key issues: § 1. Providing information about research integrity§ 2. Providing education, training and mentoring§ 3. Strengthening a research integrity culture§ 4. Facilitating open dialogue§ 5. Wise incentive management§ 6. Implementing quality assurance procedures§ 7. Improving the work environment and work satisfaction§ 8. Increasing transparency of misconduct cases§ 9. Opening up research§ 10. Implementing safe and effective whistle-blowing channels§ 11. Protecting the alleged perpetrators§ 12. Establishing a research integrity committee and appointing an ombudsperson§ 13. Making explicit the applicable standards for research integrity. (shrink)

The work of Thomas White represents a systematic attempt to combine the best of the new science of the seventeenth century with the best of Aristotelian tradition. This attempt earned him the criticism of Hobbes and the praise of Leibniz, but today, most of his attempts to navigate between traditions remain to be explored in detail. This paper does so for his ontology of accidents. It argues that his criticism of accidents in the category of location as entities over (...) and above substances was likely aimed at Francisco Suárez, and shows how White’s worries about the analysis of location were linked with his broader cosmological views. White rejects real qualities, but holds that the quantity of a substance is somehow distinct from its bearer. This reveals a common ground with some of his scholastic interlocutors, but lays bare a deep disagreement with thinkers like Descartes on the nature of matter. (shrink)

In the Summa Theologiae, I, q. 5, art. 4, Thomas argues that the good has the ratio of the final cause.1 This thesis is problematic because there seems to be a difference between the definitions and uses of “good” and “final cause.” If Thomas is arguing that the good and the final cause are in no way distinct, then why might we plausibly describe something as good even if it has no causal role? If not, then what does (...) it mean for the ratio of goodness to be the same as that of final causality? Later Thomists disagree over the precise relationship between goodness and final causality, and their disagreement is reflected in their different interpretations of the argument and conclusion of this text. Few hold that Thomas merely means to say that goodness is the fundament of being an end, or that being an end is something like a proper passion of goodness. But they disagree over what the additional connection between the two might be. (shrink)

The standard treatment of conditional probability leaves conditional probability undefined when the conditioning proposition has zero probability. Nonetheless, some find the option of extending the scope of conditional probability to include zero-probability conditions attractive or even compelling. This article reviews some of the pitfalls associated with this move, and concludes that, for the most part, probabilities conditional on zero-probability propositions are more trouble than they are worth.

This chapter lays out what we take to be the main types of justice and ethical challenges concerning those adverse effects of climate change leading to climate-related Loss and Damage (L&D). We argue that it is essential to clearly differentiate between the challenges concerning mitigation and adaptation and those ethical issues exclusively relevant for L&D in order to address the ethical aspects pertaining to L&D in international climate policy. First, we show that depending on how mitigation and adaptation are distinguished (...) from L&D, the primary focus of policy measures and their ethical implications will vary. Second, we distinguish between a distributive justice framework and a compensatory justice scheme for delivering L&D measures. Third, in order to understand the differentiated remedial responsibilities concerning L&D, we categorise the measures and policy approaches available. Fourth, depending on the kind of L&D and which remedies are possible, we explain the difference between remedial and outcome responsibilities of different actors. [Open access]. (shrink)

Is it possible for an individual that has gone out of being to come back into being again? The English Aristotelian, Thomas White, argued that it is not. Thomas Hobbes disagreed, and used the case of the Ship of Theseus to argue that individuals that have gone out of being may come back into being again. This paper provides the first systematic account of their arguments. It is doubtful that Hobbes has a consistent case against White. Still his (...) criticism may have prompted White to clarify his views on identity over time in his later work. (shrink)

We respond to Moseley and Wilkinson's defense of inner speech models of AVH.

Wayne Martin and colleagues argue that decisions about patients’ best interests must sometimes take into account the interests of others Doctors often find themselves in circumstances where they must make decisions on behalf of an incapacitated patient. As a matter of both ethics and law, such decisions must be taken in the best interests of the patient, but uncertainty remains about what is meant by best interests, especially in relation to the interests of others. Should the interests of others (...) enter into a determination of the patient’s best interests? We believe that they should and argue against a recent trend to focus solely on the patient. It only takes a moment’s reflection to appreciate that the interests of one person are often wrapped up with the interests of others. A patient has an interest in recovering from her illness, but so do her family, employer, care providers, etc. Sometimes these various interests can be independently specified, but in other cases they are inextricably intertwined. Suppose that I am a single parent whose overriding interest is to ensure the wellbeing of my children. In that case the proper specification of my best interest is a function of theirs; I simply cannot determine the one without considering the other. This can create an ethical problem in medical decision making. In circumstances where medical staff must make a decision in the best interests of an incapacitated patient, to what extent can or should they take account of the interests of other people whose lives are affected by the outcome? These ethical issues have taken on a concrete legal shape in the UK with the implementation of the Mental Capacity Act 2005, which specifies that, “An act done, or decision made, under this Act for or on behalf of a person who lacks capacity …. (shrink)

ABSTRACTTime-consciousness has long been a focus of research in phenomenology and phenomenological psychology. We advance and extend this tradition of research by focusing on the character of temporal experience under conditions of mania. Symptom scales and diagnostic criteria for mania are peppered with temporally inflected language: increased rate of speech, racing thoughts, flight-of-ideas, hyperactivity. But what is the underlying structure of temporal experience in manic episodes? We tackle this question using a strategically hybrid approach. We recover and reconstruct three hypotheses (...) regarding manic temporality that were advanced and modeled by two pioneers of clinical phenomenology: Eugène Minkowski and Ludwig Binswanger. We then test, critique, and refine these hypotheses using heterophenomenological methods in an interview-based study of persons with a history of bipolar and a current diagnosis of acute mania. Our conclusions support a central hypothesis due to Minkowski... (shrink)

Climate change and decarbonization raise complex justice questions that researchers and policymakers must address. The distributions of greenhouse gas emissions rights and mitigation efforts have dominated justice discourses within scenario research, an integrative element of the IPCC. However, the space of justice considerations is much larger. At present, there is no consistent approach to comprehensively incorporate and examine justice considerations. Here we propose a conceptual framework grounded in philosophical theory for this purpose. We apply this framework to climate mitigation scenarios (...) literature as proof of concept, enabling a more holistic and multidimensional investigation of justice. We identify areas of future research, including new metrics of service provisioning essential for human well-being. [Can be freely read by clicking the ReadCube link below.]. (shrink)

In his rich and provocative paper, Peter Carruthers announces two related theses: (a) a positive thesis that “central cognition is sensory based, depending on the activation and deployment of sensory images of various sorts” (Carruthers 2013) and (b) a negative thesis that the “central mind does not contain any workspace within which goals, decisions, intentions, or non-sensory judgments can be active” (Carruthers 2013). These are striking claims suggesting that a natural view about cognition, namely that explicit theoretical reasoning involves direct (...) operations over beliefs, is wrong. Our beliefs, on this natural view, interact with each other to yield new beliefs. If Carruthers is right, beliefs have only an indirect or mediated influence in cognition with sensory states playing the direct role. I think it an important feature of Carruthers’ discussion that he draws support from work on the neural circuits and mechanisms that subserve these processes. In what follows, I want to regis. (shrink)

Transdisciplinary research knits together knowledge from diverse epistemic communities in addressing social-environmental challenges, such as biodiversity loss, climate crises, food insecurity, and public health. This paper reflects on the roles of philosophy of science in transdisciplinary research while focusing on Indigenous and other subaltern forms of knowledge. We offer a critical assessment of demarcationist approaches in philosophy of science and outline a constructive alternative of transdisciplinary philosophy of science. While a demarcationist focus obscures the complex relations between epistemic communities, transdisciplinary (...) philosophy of science provides resources for meeting epistemic and political challenges of collaborative knowledge production. (shrink)

In this paper, by suggesting a formal representation of science based on recent advances in logic-based Artificial Intelligence (AI), we show how three serious concerns around the realisation of traditional scientific realism (the theory/observation distinction, over-determination of theories by data, and theory revision) can be overcome such that traditional realism is given a new guise as ‘naturalised’. We contend that such issues can be dealt with (in the context of scientific realism) by developing a formal representation of science based on (...) the application of the following tools from Knowledge Representation: the family of Description Logics, an enrichment of classical logics via defeasible statements, and an application of the preferential interpretation of the approach to Belief Revision. (shrink)

In this paper, the issues of computability and constructivity in the mathematics of physics are discussed. The sorts of questions to be addressed are those which might be expressed, roughly, as: Are the mathematical foundations of our current theories unavoidably non-constructive: or, Are the laws of physics computable?

B eginning with the problem of integrating diverse disciplinary perspectives on moral cognition, we argue that the various disciplines have an interest in developing a common conceptual framework for moral cognition research. We discuss issues arising in the other chapters in this volume that might serve as focal points for future investigation and as the basis for the eventual development of such a framework. These include the role of theory in binding together diverse phenomena and the role of philosophy in (...) the construction of moral theory. We discuss the problem of distinguishing descriptive and normative issues and the importance of systematic normative analysis for empirical research. We argue that theories of cognitive architecture should play an important role as a backdrop for investigation into specific aspects of moral cognition, and we consider some of the taxonomic issues that will arise for moral cognition research, including types of moral agents, forms of moral cognition, and the nature of morality itself. Finally, we discuss some key issues in moral development, including the importance of.. (shrink)

Background: Transgender health care is a subject of much debate among clinicians, political commentators, and policy-makers. While the World Professional Association of Transgender Health (WPATH) Standards of Care (SOC) establish clinical standards, these standards contain implied ethics but lack explicit focused discussion of ethical considerations in providing care. An ethics chapter in the SOC would enhance clinical guidelines. Aims: We aim to provide a valuable guide for healthcare professionals, and anyone interested in the ethical aspects of clinical support for gender (...) diverse and transgender people of all ages. Recognizing that the WPATH is a global association, we address broad challenges. We offer a reflection on general ethical principles, providing conceptual tools for healthcare providers, patients, and families to navigate the specific challenges they might encounter in transgender health care, in line with WPATH’s worldwide mission and scope. Method: This article employs a descriptive analysis, and our framework of reference is the four principles of biomedical ethics: respect for autonomy, beneficence, nonmaleficence, and justice. Results: The article presents a discussion on the four ethical principles as applied to transgender health care. We address issues such as respect for patient autonomy in decision-making, the role of beneficence and nonmaleficence in clinical interventions, and the importance of justice in equitable treatment and access to care. Some of the ethical concerns we address in this article pertain to the current sociopolitical climate, where there has been increasing legal interference, internationally, for transgender and nonbinary people, particularly youth, seeking medical care. Discussion: We highlight the interplay between ethical principles and clinical practice, underscoring the need for ethical guidance in addressing the diverse challenges faced by healthcare providers and patients in transgender health care. We advocate for continuous refinement of ethical thinking to ensure that transgender health care is not only medically effective but also ethically sound. (shrink)

The role of evolutionary theory at the origin of life is an extensively debated topic. The origin and early development of life is usually separated into a prebiotic phase and a protocellular phase, ultimately leading to the Last Universal Common Ancestor. Most likely, the Last Universal Common Ancestor was subject to Darwinian evolution, but the question remains to what extent Darwinian evolution applies to the prebiotic and protocellular phases. In this review, we reflect on the current status of evolutionary theory (...) in origins of life research by bringing together philosophy of science, evolutionary biology, and empirical research in the origins field. We explore the various ways in which evolutionary theory has been extended beyond biology; we look at how these extensions apply to the prebiotic development of (proto)metabolism; and we investigate how the terminology from evolutionary theory is currently being employed in state-of-the-art origins of life research. In doing so, we identify some of the current obstacles to an evolutionary account of the origins of life, as well as open up new avenues of research. (shrink)

In his 2004 article “Hannah Arendt and Jean Baudrillard: Pedagogy in the Consumer Society,” Trevor Norris bemoans the degree to which contemporary education’s focus can increasingly be described as primarily nurturing “consumers in training.” He goes on to add that the consequences of such “mindless” consumerism is that it “erodes democratic life, reduces education to the reproduction of private accumulation, prevents social resistance from expressing itself as anything other than political apathy, and transforms all human relations into commercial transactions of (...) calculated exchange.” This, then, is the challenge of the age: to articulate the sort of education that might prompt our youngsters to imagine a genuine alternative to this consumer madness—a challenge that the authors of this paper attempt to tackle. (shrink)

The translational research community, in general, and the Clinical and Translational Science Awards (CTSA) community, in particular, share the vision of repurposing EHRs for research that will improve the quality of clinical practice. Many members of these communities are also aware that electronic health records (EHRs) suffer limitations of data becoming poorly structured, biased, and unusable out of original context. This creates obstacles to the continuity of care, utility, quality improvement, and translational research. Analogous limitations to sharing objective data in (...) other areas of the natural sciences have been successfully overcome by developing and using common ontologies. This White Paper presents the authors’ rationale for the use of ontologies with computable semantics for the improvement of clinical data quality and EHR usability formulated for researchers with a stake in clinical and translational science and who are advocates for the use of information technology in medicine but at the same time are concerned by current major shortfalls. This White Paper outlines pitfalls, opportunities, and solutions and recommends increased investment in research and development of ontologies with computable semantics for a new generation of EHRs. (shrink)

This paper has three purposes: first, to explicate the ex istential basis of Arendt's theory of action. This will be done by first tracing the intellectual derivation of Arendt's existentialism and the modifications she made to fit it in to her public realm. Second, I will demonstrate the con nection between Arendt's existentialism and her formula tion of political freedom. Third, I will illustrate throughout that Arendt's political ideas, if they are to be properly understood, must be subsumed under her (...) existentialism .\nPart I treats Arendt's effort to find a home for the in dividual Human Being by attacking the modern tendency to make freedom an inner domain of the mind and refuge from the outside world. We will see how she uses the ideas of Heidegger and Jaspers to counter the Being of Kant and the philosophy of Mill and Augustine. Part II demonstrates her effort to make freedom a world reality and counter to the forces of totalitarianism: the modern enchantment with totality and an inexorable history. She attacks the Will, consciousness, Being, and the historical process itself.\nFinding no suitable conceptualization of freedom which makes it political by giving it a public space, Arendt turns finally to Jaspers' communicative existentialism and Duns Scotus' emphasis on contingency. (shrink)

The impossibility of an indeterministic evolution for standard relativistic quantum field theories, that is, theories in which all fields satisfy the condition that the generators of space-time translation have spectra in the forward light-cone, is demonstrated. The demonstration proceeds by arguing that a relativistically invariant theory must have a stable vacuum and then showing that stability of the vacuum, together with the requirements imposed by relativistic causality, entails deterministic evolution, if all degrees of freedom are standard degrees of freedom.

BACKGROUND Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how clinicians (...) use them and if OTAs themselves modify clinician prescribing practices. OBJECTIVE To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. DESIGN We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. PARTICIPANTS 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. APPROACH Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. KEY RESULTS Our analysis identified three main themes: (1) OTAs did not influence clinicians’ decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. CONCLUSION This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians’ decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs’ purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. (shrink)

Ever since its inception, the theory of evolution has been reified into an “-ism”: Darwinism. While biologists today tend to shy away from the term in their research, the term is still actively used in the broader academic and societal contexts. What exactly is Darwinism, and how precisely are its various uses and abuses related to the scientific theory of evolution? Some call for limiting the meaning of the term “Darwinism” to its scientific context; others call for its abolition; yet (...) others claim the term refers to a myth-like story. In this paper we propose a conceptually grounded overview of the term. We show how the scientific dimension of Darwinism feeds into, and is influenced by, guises of Darwinism as a methodology and as an ethically and politically charged “worldview”. The full meaning of Darwinism, as well as how this meaning has changed over time, can only be understood through the complex interaction between these three dimensions. (shrink)

Elections are not the solution to political crisis, they’re the problem. In lively dialogue form, The Democracy Manifesto explains why elections are anti-democratic and should be replaced with government in which decision-makers are randomly selected from the population at large.

Though the social world is real and objective, the way that social facts arise out of other facts is in an important way shaped by human thought, talk and behaviour. Building on recent work in social ontology, I describe a mechanism whereby this distinctive malleability of social facts, combined with the possibility of basic human error, makes it possible for a consistent physical reality to ground an inconsistent social reality. I explore various ways of resisting the prima facie case for (...) social inconsistency. I conclude, however, that the prima facie case survives scrutiny, and draw out some of the ramifications. (shrink)

The application of machine-learning technologies to medical practice promises to enhance the capabilities of healthcare professionals in the assessment, diagnosis, and treatment, of medical conditions. However, there is growing concern that algorithmic bias may perpetuate or exacerbate existing health inequalities. Hence, it matters that we make precise the different respects in which algorithmic bias can arise in medicine, and also make clear the normative relevance of these different kinds of algorithmic bias for broader questions about justice and fairness in healthcare. (...) In this paper, we provide the building blocks for an account of algorithmic bias and its normative relevance in medicine. (shrink)