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)

The Neurological Disease Ontology (ND) is being developed to provide a comprehensive framework for the representation of neurological diseases (Diehl et al., 2013). ND utilizes the model established by the Ontology for General Medical Science (OGMS) for the representation of entities in medicine and disease (Scheuermann et al., 2009). The goal of ND is to include information for each disease concerning its molecular, genetic, and environmental origins, the processes involved in its etiology and realization, as well as its clinical presentation (...) including signs and symptoms. (shrink)

Philosophers working in the nascent field of ‘experimental philosophy’ have begun using methods borrowed from psychology to collect data about folk intuitions concerning debates ranging from action theory to ethics to epistemology. In this paper we present the results of our attempts to apply this approach to the free will debate, in which philosophers on opposing sides claim that their view best accounts for and accords with folk intuitions. After discussing the motivation for such research, we describe our methodology of (...) surveying people’s prephilosophical judgments about the freedom and responsibility of agents in deterministic scenarios. In two studies, we found that a majority of participants judged that such agents act of their own free will and are morally responsible for their actions. We then discuss the philosophical implications of our results as well as various difficulties inherent in such research. (shrink)

Products made from animal fur and skin have been a major part of human civilization. However, in modern society, the unsustainable consumption of these products – often considered luxury goods – has many negative environmental impacts. This study explores how people’s perceptions of biodiversity affect their attitudes and behaviors toward consumption. To investigate the information process deeper, we add the moderation of beliefs about biodiversity loss. Following the Bayesian Mindsponge Framework (BMF) analytics, we use mindsponge-based reasoning for constructing conceptual models (...) and employ Bayesian analysis aided by Markov Chain Monte Carlo (MCMC) algorithms on a dataset of 535 Vietnamese urban residents. The results show that people’s preference for using products made from animal skin/fur is negatively associated with perceived consequences of biodiversity loss when they believe biodiversity loss is real and a major problem. In contrast, if urban residents believe biodiversity loss is unreal or not a significant issue, the association between perceived consequences of biodiversity loss and personal preference happens in the opposite direction. The same effects of biodiversity loss perception on people’s possession of skin/fur products was not found, indicating a more complex information process on behaviors compared to attitudes. Nevertheless, in the scenario that people believe biodiversity loss is not a significant issue, the higher the perceived consequences of biodiversity loss are, the greater number of animal-based products they likely own. Our results suggest that policymakers should not neglect the factor of personal belief besides knowledge and awareness in environmental campaigns. (shrink)

Every day, thousands of polls, surveys, and rating scales are employed to elicit the attitudes of humankind. Given the ubiquitous use of these instruments, it seems we ought to have firm answers to what is measured by them, but unfortunately we do not. To help remedy this situation, we present a novel approach to investigate the nature of attitudes. We created a self-transforming paper survey of moral opinions, covering both foundational principles, and current dilemmas hotly debated in the media. This (...) survey used a magic trick to expose participants to a reversal of their previously stated attitudes, allowing us to record whether they were prepared to endorse and argue for the opposite view of what they had stated only moments ago. The result showed that the majority of the reversals remained undetected, and a full 69% of the participants failed to detect at least one of two changes. In addition, participants often constructed coherent and unequivocal arguments supporting the opposite of their original position. These results suggest a dramatic potential for flexibility in our moral attitudes, and indicates a clear role for self-attribution and post-hoc rationalization in attitude formation and change. (shrink)

Judgments of blame for others are typically sensitive to what an agent knows and desires. However, when people act negligently, they do not know what they are doing and do not desire the outcomes of their negligence. How, then, do people attribute blame for negligent wrongdoing? We propose that people attribute blame for negligent wrongdoing based on perceived mental control, or the degree to which an agent guides their thoughts and attention over time. To acquire information about others’ mental control, (...) people self-project their own perceived mental control to anchor third-personal judgments about mental control and concomitant responsibility for negligent wrongdoing. In four experiments (N = 841), we tested whether perceptions of mental control drive third-personal judgments of blame for negligent wrongdoing. Study 1 showed that the ease with which people can counterfactually imagine an individual being non-negligent mediated the relationship between judgments of control and blame. Studies 2a and 2b indicated that perceived mental control has a strong effect on judgments of blame for negligent wrongdoing and that first-personal judgments of mental control are moderately correlated with third-personal judgments of blame for negligent wrongdoing. Finally, we used an autobiographical memory manipulation in Study 3 to make personal episodes of forgetfulness salient. Participants for whom past personal episodes of forgetfulness were made salient judged negligent wrongdoers less harshly compared to a control group for whom past episodes of negligence were not salient. Collectively, these findings suggest that first-personal judgments of mental control drive third-personal judgments of blame for negligent wrongdoing and indicate a novel role for counterfactual thinking in the attribution of responsibility. (shrink)

A question arising from the COVID-19 crisis is whether the merits of cases for climate policies have been affected. This article focuses on carbon pricing, in the form of either carbon taxes or emissions trading. It discusses the extent to which relative costs and benefits of introducing carbon pricing may have changed in the context of COVID-19, during both the crisis and the recovery period to follow. In several ways, the case for introducing a carbon price is stronger during the (...) COVID-19 crisis than under normal conditions. Oil costs are lower than normal, so we would expect less harm to consumers compared to normal conditions. Governments have immediate need for diversified new revenue streams in light of both decreased tax receipts and greater use of social safety nets. Finally, supply and demand shocks have led to already destabilized supply-side activities, and carbon pricing would allow this destabilization to equilibrate around greener production for the long-term. The strengthening of the case for introducing carbon pricing now is highly relevant to discussions about recovery measures, especially in the context of policy announcements from the European Union and United States House of Representatives. Key Policy Insights: • Persistently low oil prices mean that consumers will face lower pain from carbon pricing than under normal conditions. • Many consumers are more price-sensitive during the COVID-19 context, which suggests that a greater relative burden from carbon prices would fall upon producers as opposed to consumers than under normal conditions. • Carbon prices in the COVID-19 context can introduce new revenue streams, assisting with fiscal holes or with other green priorities. • Carbon pricing would contribute to a more sustainable COVID-19 recovery period, since many of the costs of revamping supply chains are already being felt while idled labor capacity can be incorporated into firms with lower carbon-intensity. (shrink)

Despite the recent proliferation of scientific, clinical, and narrative accounts of auditory verbal hallucinations, the phenomenology of voice hearing remains opaque and undertheorized. In this article, we outline an interdisciplinary approach to understanding hallucinatory experiences which seeks to demonstrate the value of the humanities and social sciences to advancing knowledge in clinical research and practice. We argue that an interdisciplinary approach to the phenomenology of AVH utilizes rigorous and context-appropriate methodologies to analyze a wider range of first-person accounts of AVH (...) at 3 contextual levels: cultural, social, and historical; experiential; and biographical. We go on to show that there are significant potential benefits for voice hearers, clinicians, and researchers. These include informing the development and refinement of subtypes of hallucinations within and across diagnostic categories; “front-loading” research in cognitive neuroscience; and suggesting new possibilities for therapeutic intervention. In conclusion, we argue that an interdisciplinary approach to the phenomenology of AVH can nourish the ethical core of scientific enquiry by challenging its interpretive paradigms, and offer voice hearers richer, potentially more empowering ways to make sense of their experiences. (shrink)

Philosophers often suggest that their theories of free will are supported by our phenomenology. Just as their theories conflict, their descriptions of the phenomenology of free will often conflict as well. We suggest that this should motivate an effort to study the phenomenology of free will in a more systematic way that goes beyond merely the introspective reports of the philosophers themselves. After presenting three disputes about the phenomenology of free will, we survey the (limited) psychological research on the experiences (...) relevant to the philosophical debates and then describe some pilot studies of our own with the aim of encouraging further research. The data seem to support compatibilist descriptions of the phenomenology more than libertarian descriptions. We conclude that the burden is on libertarians to find empirical support for their more demanding metaphysical theories with their more controversial phenomenological claims. (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)

Recent scholarship in intellectual humility (IH) has attempted to provide deeper understanding of the virtue as personality trait and its impact on an individual's thoughts, beliefs, and actions. A limitations-owning perspective of IH focuses on a proper recognition of the impact of intellectual limitations and a motivation to overcome them, placing it as the mean between intellectual arrogance and intellectual servility. We developed the Limitations-Owning Intellectual Humility Scale to assess this conception of IH with related personality constructs. In Studies 1 (...) (n= 386) and 2 (n = 296), principal factor and confirmatory factor analyses revealed a three-factor model – owning one's intellectual limitations, appropriate discomfort with intellectual limitations, and love of learning. Study 3 (n = 322) demonstrated strong test-retest reliability of the measure over 5 months, while Study 4 (n = 612) revealed limitations-owning IH correlated negatively with dogmatism, closed-mindedness, and hubristic pride and positively with openness, assertiveness, authentic pride. It also predicted openness and closed-mindedness over and above education, social desirability, and other measures of IH. The limitations-owning understanding of IH and scale allow for a more nuanced, spectrum interpretation and measurement of the virtue, which directs future study inside and outside of psychology. (shrink)

Abstract. The aim of this paper is to present a topological method for constructing discretizations (tessellations) of conceptual spaces. The method works for a class of topological spaces that the Russian mathematician Pavel Alexandroff defined more than 80 years ago. Alexandroff spaces, as they are called today, have many interesting properties that distinguish them from other topological spaces. In particular, they exhibit a 1-1 correspondence between their specialization orders and their topological structures. Recently, a special type of Alexandroff spaces was (...) used by Ian Rumfitt to elucidate the logic of vague concepts in a new way. According to his approach, conceptual spaces such as the color spectrum give rise to classical systems of concepts that have the structure of atomic Boolean algebras. More precisely, concepts are represented as regular open regions of an underlying conceptual space endowed with a topological structure. Something is subsumed under a concept iff it is represented by an element of the conceptual space that is maximally close to the prototypical element p that defines that concept. This topological representation of concepts comes along with a representation of the familiar logical connectives of Aristotelian syllogistics in terms of natural settheoretical operations that characterize regular open interpretations of classical Boolean propositional logic. In the last 20 years, conceptual spaces have become a popular tool of dealing with a variety of problems in the fields of cognitive psychology, artificial intelligence, linguistics and philosophy, mainly due to the work of Peter Gärdenfors and his collaborators. By using prototypes and metrics of similarity spaces, one obtains geometrical discretizations of conceptual spaces by so-called Voronoi tessellations. These tessellations are extensionally equivalent to topological tessellations that can be constructed for Alexandroff spaces. Thereby, Rumfitt’s and Gärdenfors’s constructions turn out to be special cases of an approach that works for a more general class of spaces, namely, for weakly scattered Alexandroff spaces. This class of spaces provides a convenient framework for conceptual spaces as used in epistemology and related disciplines in general. Alexandroff spaces are useful for elucidating problems related to the logic of vague concepts, in particular they offer a solution of the Sorites paradox (Rumfitt). Further, they provide a semantics for the logic of clearness (Bobzien) that overcomes certain problems of the concept of higher2 order vagueness. Moreover, these spaces help find a natural place for classical syllogistics in the framework of conceptual spaces. The crucial role of order theory for Alexandroff spaces can be used to refine the all-or-nothing distinction between prototypical and nonprototypical stimuli in favor of a more fine-grained gradual distinction between more-orless prototypical elements of conceptual spaces. The greater conceptual flexibility of the topological approach helps avoid some inherent inadequacies of the geometrical approach, for instance, the so-called “thickness problem” (Douven et al.) and problems of selecting a unique metric for similarity spaces. Finally, it is shown that only the Alexandroff account can deal with an issue that is gaining more and more importance for the theory of conceptual spaces, namely, the role that digital conceptual spaces play in the area of artificial intelligence, computer science and related disciplines. Keywords: Conceptual Spaces, Polar Spaces, Alexandroff Spaces, Prototypes, Topological Tessellations, Voronoi Tessellations, Digital Topology. (shrink)

Rather than answering the broad question, ‘What is a just income?’, in this essay I consider one component of income—economic rent—under one understanding of justice—as giving people what they deserve. As it turns out, the answer to this more focused question is ‘no’. People do not deserve their economic rents, and there is no bar of justice to their confiscation. After briefly covering the concept of desert and explaining what economic rents are, I analyze six types of rent and show (...) that each is unjustified from the point of view of desert. I conclude by drawing some political and economic lessons from the preceding analysis, and by describing how these considerations can create a more just and efficient economy. (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)

Mental and behavioral disorders represent a significant portion of the public health burden in all countries. The human cost of these disorders is immense, yet treatment options for sufferers are currently limited, with many patients failing to respond sufficiently to available interventions and drugs. High quality ontologies facilitate data aggregation and comparison across different disciplines, and may therefore speed up the translation of primary research into novel therapeutics. Realism-based ontologies describe entities in reality and the relationships between them in such (...) a way that – once formulated in a suitable formal language – the ontologies can be used for sophisticated automated reasoning applications. Reference ontologies can be applied across different contexts in which different, and often mutually incompatible, domain-specific vocabularies have traditionally been used. In this contribution we describe the Mental Functioning Ontology (MF) and Mental Disease Ontology (MD), two realism-based ontologies currently under development for the description of humanmental functioning and disease. We describe the structure and upper levels of the ontologies and preliminary application scenarios, and identify some open questions. (shrink)

This essay reads acclaimed poet James Galvin’s 1992 semi-autobiographical novel through the lenses of Martin Heidegger’s notion of authenticity and Patrick Wolfe’s discussion of settler-colonialism. I argue that Lyle, arguably the novel’s main character, is portrayed as living “authentically” in contrast to the deep inauthenticity of Ferris. I connect Western authentic dwelling with settler-colonial logic, centering my account on the figures of the “lazy” and “magical” “Indian.” Ultimately, I find that far from rejecting settler-colonial logic Galvin’s text plays out of (...) a return of the repressed of the present absence of indigenous persons in the land and the text. (shrink)

We have begun work on two separate but related ontologies for the study of neurological diseases. The first, the Neurological Disease Ontology (ND), is intended to provide a set of controlled, logically connected classes to describe the range of neurological diseases and their associated signs and symptoms, assessments, diagnoses, and interventions that are encountered in the course of clinical practice. ND is built as an extension of the Ontology for General Medical Sciences — a high-level candidate OBO Foundry ontology that (...) provides a set of general classes that can be used to describe general aspects of medical science. ND is being built with classes utilizing both textual and axiomatized definitions that describe and formalize the relations between instances of other classes within the ontology itself as well as to external ontologies such as the Gene Ontology, Cell Ontology, Protein Ontology, and Chemical Entities of Biological Interest. In addition, references to similar or associated terms in external ontologies, vocabularies and terminologies are included when possible. Initial work on ND is focused on the areas of Alzheimer’s and other diseases associated with dementia, multiple sclerosis, and stroke and cerebrovascular disease. Extensions to additional groups of neurological diseases are planned. The second ontology, the Neuro-Psychological Testing Ontology (NPT), is intended to provide a set of classes for the annotation of neuropsychological testing data. The intention of this ontology is to allow for the integration of results from a variety of neuropsychological tests that assay similar measures of cognitive functioning. Neuro-psychological testing is an important component in developing the clinical picture used in the diagnosis of patients with a range of neurological diseases, such as Alzheimer’s disease and multiple sclerosis, and following stroke or traumatic brain injury. NPT is being developed as an extension to the Ontology for Biomedical Investigations. (shrink)

We are developing the Neurological Disease Ontology (ND) to provide a framework to enable representation of aspects of neurological diseases that are relevant to their treatment and study. ND is a representational tool that addresses the need for unambiguous annotation, storage, and retrieval of data associated with the treatment and study of neurological diseases. ND is being developed in compliance with the Open Biomedical Ontology Foundry principles and builds upon the paradigm established by the Ontology for General Medical Science (OGMS) (...) for the representation of entities in the domain of disease and medical practice. Initial applications of ND will include the annotation and analysis of large data sets and patient records for Alzheimer’s disease, multiple sclerosis, and stroke. (shrink)

There is a close conceptual relation between the notions of religious disenchantment and scientific naturalism. One way of resisting philosophical and cultural implications of the scientific image and the subsequent process of disenchantment can be found in attempts at sketching a reenchanted worldview. The main issue of accounts of reenchantment can be a rejection of scientific results in a way that flies in the face of good reason. Opposed to such reenchantment is scientific naturalism which implies an entirely disenchanted worldview. (...) However, one of the main problems of scientific naturalism are placement problems. A reenchanted worldview does have the conceptual resources to avoid placement problems, yet seems to throw out the baby with the bathwater. A dilemma results: the Scylla of an undesirable scientific naturalism and the Charybdis of a rampant, seemingly prescientific reenchanted worldview. In this article I argue that there is a safe middle passage between these two options, i.e. the recently proposed liberal naturalism which allows for a moderate normative reenchantment. Liberal naturalism lets us have it both ways: avoiding the placement problems while retaining a necessary and reasonable adherence to science, thereby avoiding both an all-too restrictive scientific naturalism. (shrink)

This paper explores the idea of moral offsetting: the idea that good actions can offset bad actions in a way roughly analogous to carbon offsetting. For example, a meat eater might try to offset their consumption of meat by donating to an animal welfare charity. In this paper, I clarify the idea of moral offsetting, consider whether the leading moral theories and theories of moral worth are consistent with the possibility of moral offsetting, and consider potential benefits of moral offsetting. (...) I also compare moral offsetting to a related practice that I call ‘moral triaging’. (shrink)

Prospective parents are sometimes partial towards their future children, engaging in what I call ‘pre-parental partiality’. Common sense morality is as permissive of pre-parental partiality as it is of ordinary parental partiality—partiality towards one’s existing children. But I argue that existing justifications for partiality typically establish weaker reasons in support of pre-parental partiality than in support of parental partiality. Thus, either these existing justifications do not fully account for our reasons of parental partiality, or our reasons to engage in pre-parental (...) partiality are indeed typically weaker than our reasons to engage in parental partiality. (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)

McDowell and Merleau-Ponty share a critical attitude towards a certain Cartesian picture of the mind. According to the picture in question nothing which properly belongs to subjectivity can be hidden to the subject herself. Nevertheless there is a striking asymmetry in how the two philosophers portray the problematic consequences of such a picture. They can seem to offer exact opposite views of these consequences, which, given the almost identical characterization of the transparency claim, is puzzling. I argue that a closer (...) look at the prima facie puzzling asymmetry dissolves the apparent disagreement and reveals a deeper agreement concerning both the nature and the origin of the problems haunting the Cartesian picture in question. Both McDowell and Merleau-Ponty argue that on the picture of the relation of between mind and world in question, we lose our grip on the very idea of a perceptual appearance. Furthermore, the two authors regard a certain conception of nature as conceived in the image of science, as one of the crucial elements in making the picture of the mind in question look attractive. (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)

Purpose. The purpose of this study is to investigate how professionals learn from varying experiences with errors in health-care digitalization and develop and use negative knowledge and digital ignorance in efforts to improve digitalized health care. Design/methodology/approach. A two-year qualitative field study was conducted in the context of a public health-care organization working with digital patient communication. The data consisted of participant observation, semistructured interviews and document data. Inductive coding and a theoretically informed generation of themes were applied. Findings. The (...) findings show that both health-care and digital communication professionals learn through experiences with digital “rule-” and “knowledge-based” errors in patient communication and develop negative knowledge and awareness of digital ignorance. In their joint efforts, they use negative knowledge to “bend the rules” and to explore digital ignorance in efforts to improve patient communication. Originality/value. This study provides insight into the importance of collaboration between professionals with varying experience of errors in digitalizing patient communication. Such collaboration is required to acknowledge own shortcomings and create complementary negative knowledge to improve digital patient communication. This is particularly important when working with innovative digitalization in health care. (shrink)

A recent challenge to statist arguments defending the right of states to exclude prospective immigrants maintains that such statist arguments prove too much. Specifically, the challenge argues that statist arguments, insofar as they are correct, entail that states may permissibily exclude current members' newcomers by birth, which seems to violate a widely held intuition that members' newcomers by birth ought automatically to be granted membership rights. The basic claim is that statist arguments cannot account for the differntial treatment between prospective (...) immigrants and newcomers by birth. Call this the newcomer-by-birth objection. This article rejects the newcomer-by-birth rejection. It begins by sketching the precise extent to which the objection applies to statist arguments. It then examines the case of newcomers by birth and argues for a principled basis for treating them differentially from prospective immigrants such that a right to exclude prospective immigrants need not entail a right to exclude newcomers by birth. But this distinction holds only in most cases, not all, and therefore the newcomer-by-birth objection is not entirely defeated. With respect to the cases in which the objection does hold, it is argued that such cases are morally akin to international adoption, and thus morally benign. All considered, statist arguments easily survive the newcomer-by-birth objection. (shrink)

Instability occurs when the very fact of choosing one particular possible option rather than another affects the expected values of those possible options. In decision theory: An act is stable iff given that it is actually performed, its expected utility is maximal. When there is no stable choice available, the resulting instability can seem to pose a dilemma of practical rationality. A structurally very similar kind of instability, which occurs in cases of anti-expertise, can likewise seem to create dilemmas of (...) epistemic rationality. One possible line of response to such cases of instability, suggested by both Jeffrey (1983) and Sorensen (1987), is to insist that a rational agent can simply refuse to accept that such instability applies to herself in the first place. According to this line of thought it can be rational for a subject to discount even very strong empirical evidence that the anti-expertise condition obtains. I present a new variety of anti-expertise condition where no particular empirical stage-setting is required, since the subject can deduce a priori that an anti-expertise condition obtains. This kind of anti-expertise case is therefore not amenable to the line of response that Jeffrey and Sorensen recommend. (shrink)

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)

In this issue, Elizabeth Shaw and Gulzaar Barn offer a number of replies to my arguments in ‘Criminal Rehabilitation Through Medical Intervention: Moral Liability and the Right to Bodily Integrity’, Journal of Ethics. In this article I respond to some of their criticisms.

It is sometimes claimed that those who succeed with the aid of enhancement technologies deserve the rewards associated with their success less, other things being equal, than those who succeed without the aid of such technologies. This claim captures some widely held intuitions, has been implicitly endorsed by participants in social-psychological research, and helps to undergird some otherwise puzzling philosophical objections to the use of enhancement technologies. I consider whether it can be provided with a rational basis. I examine three (...) arguments that might be offered in its favor and argue that each either shows only that enhancements undermine desert in special circumstances, or succeeds only under assumptions that deprive the appeal to desert of much of its dialectic interest. (shrink)

People often engage in “offline simulation”, considering what would happen if they performed certain actions in the future, or had performed different actions in the past. Prior research shows that these simulations are biased towards actions a person considers to be good—i.e., likely to pay off. We ask whether, and why, this bias might be adaptive. Through computational experiments we compare five agents who differ only in the way they engage in offline simulation, across a variety of different environment types. (...) Broadly speaking, our experiments reveal that simulating actions one already regards as good does in fact confer an advantage in downstream decision making, although this general pattern interacts with features of the environment in important ways. We contrast this bias with alternatives such as simulating actions whose outcomes are instead uncertain. (shrink)

Minimalism about truth is one of the main contenders for our best theory of truth, but minimalists face the charge of being unable to properly state their theory. Donald Davidson incisively pointed out that minimalists must generalize over occurrences of the same expression placed in two different contexts, which is futile. In order to meet the challenge, Paul Horwich argues that one can nevertheless characterize the axioms of the minimalist theory. Sten Lindström and Tim Button have independently argued that Horwich’s (...) attempt to formulate minimalism remains unsuccessful. We show how to properly state Horwich’s axioms by appealing to propositional functions that are given by definite descriptions. Both Lindström and Button discuss proposals similar to ours and conclude that they are unsuccessful. Our new suggestion avoids these objections. (shrink)

According to the so-called Classical Theory, concepts are mentally represented by individually necessary and jointly sufficient application conditions. One of the principal empirical objections against this view stems from evidence that people judge some instances of a concept to be more typical than others. In this paper we present and discuss four empirical studies that investigate the extent to which this ‘typicality effect’ holds for the concept of basic needs. Through multiple operationalizations of typicality, our studies yielded evidence for a (...) strong effect of this kind: Participants tended to recall the same core examples of the concept in a free-listing task. They judged some basic needs to be more typical than others. The items that were judged to be more typical were listed more frequently in the free-listing task. These items were listed earlier on in the free-listing task. Typical basic needs, as well as non needs, were classified faster than atypical basic needs in a reaction time study. These findings suggest that the concept of basic needs may have a non-classical structure. If so, the quest for a simple and robust intensional analysis of the concept may be futile. (shrink)

The success of the early music movement has long raised questions about performing historical works: Should musicians perform on period instruments and try to reconstruct the original style? If a historically “authentic” performance is impossible or undesirable, what should be the goal of the early music movement? I turn to Gadamer to answer these questions by constructing the outlines of a hermeneutics of early music performance. In the first half of the paper, I examine Gadamer’s critique of historical reconstruction and (...) argue that this critique sheds light on mistaken tendencies and misunderstandings within the early music movement, but it does not discredit the movement as such. In the second half of the paper, I attempt to show how Gadamer’s dialogical account of historical consciousness provides a framework for understanding what historically informed performance is seeking to accomplish, as well as its advantage over a Nietzschean approach. (shrink)

This paper walks through four different approaches to Hegel's notion of Consciousness in the Phenomenology of Spirit. Through taking four different approaches our aim is to explore the multifaceted nature of the phenomenological movement of consciousness. The first part provides an overview of the three chapters of the section on Consciousness, namely Sense-Certainty, Perception and Force and the Understanding, attempting to unearth the implicit logic that undergirds Consciousness’ experience. The second part focuses specifically on the shape of Sense-Certainty, providing an (...) analysis of the movement from Sense-Certainty to Perception from a neuroscientific view. Thirdly, we consider an inferentialist reading of the chapters on Consciousness which has been made popular by Robert Brandom. We think that while this view elucidates the connection that Hegel draws between meaning and use, it fails to account for the vital place of immediacy in each of the shapes. Finally, the fourth part suggests that Hegel’s notion of Consciousness improves the reading of tragedy he develops in chapters 5 and 7 of the Phenomenology. While many critics have noted that Hegel fails to do justice to tragic experience, Consciousness contains an epistemology that develops analogously to the heroes of ancient tragedy. Each approach in this paper comes at Hegel’s description of the journey of Consciousness from a different angle, and together they paint a multi-layered picture of a highly important part of Hegel’s corpus. (shrink)

What we traditionally call ‘conscious thought’ actually is a subpersonal process, and only rarely a form of mental action. The paradigmatic, standard form of conscious thought is non-agentive, because it lacks veto-control and involves an unnoticed loss of epistemic agency and goal-directed causal self-determination at the level of mental content. Conceptually, it must be described as an unintentional form of inner behaviour. Empirical research shows that we are not mentally autonomous subjects for about two thirds of our conscious lifetime, because (...) while conscious cognition is unfolding, it often cannot be inhibited, suspended, or terminated. The instantiation of a stable first- person perspective as well as of certain necessary conditions of personhood turn out to be rare, graded, and dynamically variable properties of human beings. I argue that individual representational events only become part of a personal-level process by being functionally integrated into a specific form of transparent conscious self-representation, the ‘epistemic agent model’. The EAM may be the true origin of our consciously experienced firstperson perspective. (shrink)

Information technology (IT) is continuously making astounding progress in technical efficiency. The time, space, material and energy needed to provide a unit of IT service have decreased by three orders of magnitude since the first personal computer (PC) was sold. However, it seems difficult for society to translate IT’s efficiency progress into progress in terms of individual, organizational or socio-economic goals. In particular it seems to be difficult for individuals to work more efficiently, for organizations to be more productive and (...) for the socio-economic system to be more sustainable by using increasingly efficient IT. This article provides empirical evidence and potential explanations for this problem. Many counterproductive effects of IT can be explained economically by rebound effects. Beyond that, we conclude that the technological determinism adopted by decision-makers is the main obstacle in translating IT’s progress into non-technical goals. (shrink)

We can cause windows to break and we can break windows; we can cause villages to flood and we can flood villages; and we can cause chocolate to melt and we can melt chocolate. Each time these can come apart: if, for example, A merely instructs B to break the window, then A causes the window to break without breaking it herself. Each instance of A breaking/flooding/melting/burning/killing/etc. something, is an instance of what I call making. I argue that making is (...) an independent, theoretically important notion—akin but irreducible to causing—and metaphysicians should pay attention to it. (shrink)

Whipple disease is a rare, infectious, disease first described from a single case by Whipple in 1907. As well as characterising the clinical and pathological features of the condition, Whipple made two suggestions regarding its aetiology. These were either than the disease was caused by an infectious agent, or that it was of metabolic origin. As the disease is now thought to be caused by infection with the bacterium Tropheryma whipplei, historical reviews of the history of the disease typically mention (...) only the first of these suggestions. In this paper, we therefore revisit Whipple’s other theory. We argue that a diverse and often successful research programme was developed around this mechanism of disease causation which gave rise to many useful findings on the condition. In the later parts of this article, we then turn to discuss the surprising neglect of this period of Whipple disease research in the current literature, and conclude by offering a brief reconstruction of this early history suitable for use in a technical context. (shrink)

The idea that Derrida kept silent on Marx before the publication of Spectres de Marx, in 1993, has become a commonplace in Derrida studies and in the history of Marxism and French 20th century political thought. This idea has often been accompanied by a certain representation of the relationship between deconstruction and dialectical materialism, and fed the legend of deconstruction’s «apoliticism» – at least before what some have called Derrida’s «ethicopolitical turn», usually dated in the early 1990s. Against this narrative, (...) this essay analyzes Derrida’s notorious «silence on Marx» before Specters of Marx from the perspective of the archives. Archival research transforms the narrative: Derrida’s «silence on Marx» was only «relative». Beyond the scene of publications, archives reveal another scene: multiple engagements with Marx and Marxist thought, marked and remarked in many archival documents – more particularly in a series of early seminar notes from the 1960s and 1970s. How does this archival scene transform our interpretation of Derrida’s «silence»? (shrink)

In view of scholarly work that has explored the socio-psycho significance of national performativity, the body and the “other,” this article critically analyses newspaper representations of the Canadian-born British tennis player Greg Rusedski. Drawing on Lacanian interpretations of the body, it illustrates how Rusedski’s media framing centered on a particular feature of his body—his “smile.” In doing so, we detail how Rusedski’s “post-imperial” Otherness—conceived as a form of “extimacy” (extimité)—complicated any clear delineation between “us” and “them,” positing instead a dialectical (...) understanding of the splits, voids and contradictions that underscore the national “us.”. (shrink)

Overview of the definition of art and its relationship to definitions of the individual art forms, with an eye to clarifying the issues separating dominant institutionalist and skeptical positions from non-skeptical, non-institutional ones. Section 2 indicates some of the key philosophical issues which intersect in discussions of the definition of art, and singles out some important areas of broad agreement and disagreement. Section 3 critically reviews some influential standard versions of institutionalism, and some more recent variations on them. Section 4 (...) discusses some recent reductionist approaches to definitional questions, which advocate a shift of philosophical focus from the macro- to the micro-level —from art to the individual art forms. Section 5 outlines an alternative, non-institutionalist and non-reductionist approach to definitional questions. (shrink)

Abstract. In Dynamics of Reason Michael Friedman proposes a kind of synthesis between the neokantianism of Ernst Cassirer, the logical empiricism of Rudolf Carnap, and the historicism of Thomas Kuhn. Cassirer and Carnap are to take care of the Kantian legacy of modern philosophy of science, encapsulated in the concept of a relativized a priori and the globally rational or continuous evolution of scientific knowledge,while Kuhn´s role is to ensure that the historicist character of scientific knowledge is taken seriously. (...) More precisely, Carnapian linguistic frameworks, guarantee that the evolution of science procedes in a rational manner locally,while Cassirer’s concept of an internally defined conceptual convergence of empirical theories provides the means to maintain the global continuity of scientific reason. In this paper it is argued that Friedman’s neokantian account of scientific reason based on the concept of the relativized a priori underestimates the pragmatic aspects of the dynamics of scientific reason. To overcome this short-coming, I propose to reconsider C.I. Lewis’s account of a pragmatic the priori, recently modernized and elaborated by Hasok Chang. This may be<br><br><br><br><br><br><br><br><br><br&g t;<br><br><br><br><br><br>Keywords: Dynamics of reason, Paradigms, Logical Empiricism,Neokantianism, Pragmatism, Mathematics, Communicative Rationality. (shrink)