This article addresses the question whether and how literary documents can be used to further our understanding of a number of key issues on the agenda of the philosophy of biology such as “complexity” and “reductionism”. Kant already granted a certain respectability to aesthetical experiences of nature in his third Critique. Subsequently, the philosophical movement known as phenomenology often used literary sources and literary techniques to criticize and question mainstream laboratory science. The article discusses a number of literary documents, from (...) Moby-Dick to Jurassic Park, that explicitly stage a confrontation between scientific and non-scientific ways of experiencing and understanding the natural world. Special attention is given to the work of Michael Crichton. Its relevance for the philosophy of biology is pointed out. (shrink)

ArgumentIn calling psychoanalysis a “school of suspicion”, Ricoeur marks at once its use in a disposition characteristic of modernity: the disposition of suspicion. Modernity gives rise to various forms of suspicion, to modern forms of ressentiment and practices of disciplining oneself as well as to an epistemology of suspicion. In this essay, I shall analyze the epistemological function of suspicion – which as the “paradigm of clues” becomes the leading paradigm of the human sciences in the last third of (...) the nineteenth century – and its close interrelationship with the techniques of power. As I shall demonstrate through a comparative reading of psychoanalytical, literary, and criminological texts, the modern production of knowledge in the human sciences cannot be separated from the modern “micro-physics of power,” which for Foucault was established in the eighteenth century, and the technologies of the self. I shall situate the paradigm of clues within the framework of the modern disposition of suspicion in order to combine the epistemological reflections with an analysis of cultural history. Thus I will first examine the paradigm of clues from the perspectives of cultural theory and semiotics, in order to illuminate the structural unreliability of the episteme as well as the way it is closely linked to the techniques of power. In what follows, I will apply this view to Bertillon's photographic identification system, the psychoanalytical concept of the trace, and Kafka's short story The Burrow. (shrink)

Caring to Know by Vrinda Dalmiya is a remarkable, and remarkably original, work. It develops a significant extension of the care-ethical framework for epistemology, builds on as well as critiques Western feminist philosophy, and offers an original interpretation of the Mahābhārata's implication for epistemic norms. But perhaps most importantly, it invents an entirely original epistemology unlike anything, really, in English. The revolutionary dimensions of the book are clear from the beginning: this is a work of decolonial epistemology.For (...) the period of our shared presence in the profession of philosophy, moral theory and epistemology have begun a cautious conversation. There is now moral epistemology, a field of... (shrink)

The aim of this article is to explore the complex forms of knowledge involved in diagnostic and interventional decision making by comparing the processes in medicine and nursing, including nurse practitioners. Many authors assert that the practice of clinical decision making involves the application of theoretical knowledge (acquired in the classroom and textbooks) as well as research evidence, upon concrete particular cases. This approach draws on various universal principles and algorithms to facilitate the task. On the other hand, others argue (...) that this involves an intuitive form of judgement that is difficult to teach, one that is acquired principally through experience. In an exploration of these issues, this article consists of three sections. A clarification of terms commonly used when discussing decision making is provided in the first section. In the second section, an epistemological analysis of decision making is presented by examining several perspectives and comparing them for their use in the nursing and medical literature. Bunge's epistemological framework for decision making (based on scientific realism) is explored for its fit with the aims of medicine and nursing. The final section presents a discussion of knowledge utilization and decision making as it relates to the implications for the education and ongoing development of nurse practitioners. It is concluded that Donald Schön's conception of reflective practice best characterizes the skilful conduct of clinical decision making. (shrink)

This book is a cross-cultural intervention in analytic epistemology that offers an alternative to the narrow conception of knowledge as justified true belief. It develops a framework for a comparative epistemology, illustrating the hermeneutic circularity of knowing to accurately and responsibly approach both Western and non-Western philosophy.

The manuscript explores the plausibility of care-based epistemology in a comparative key. Investigating the epistemic virtue of care-giving, the work weaves together insights from care ethics, virtue epistemology and a particular reading of the Mah=abh=arata which, left to themselves, do not appear compatible with one another. Drawing on these traditions, the work goes on to provide a feminist vision of search for truth that is consistent with both ethical relations and interventions for justice.

With his influence on the development of physiology, physics and geometry, Hermann von Helmholtz – like few scientists of the second half of the 19th century – is representative of the research in natural science in Germany. The development of his understanding of science is not less representative. Until the late sixties, he emphatically claimed the truth of science; later on, he began to see the conditions for the validity of scientific knowledge in relative terms, and this can, in summary, (...) be referred to as hypothesizing. Already in the past century, HeImholtz made first approaches to an understanding of science, which were incompatible with his own former position and which pointed to the modern age to an astonishingly large extent. A comparison with Karl R. Popper's logic of research will illustrate how closely he nevertheless approached modern understanding of science. In Popper's logic of research, hypothesizing of scientific knowledge is definitely much more advanced than in Helmholtz's theory of science. What begins vaguely to emerge with Helmholtz has already become an explicitly formulated programme with Popper. Although HeImholtz and Popper are not on a direct line of epistemological development and Popper refers to HeImholtz only rarely and casually, there are in fact surprising points of contact which have not been taken notice of so far and which appear above all if one looks at Helmholtz's understanding of science against the background of Popper's logic of research. (shrink)

Which epistemic value is the standard according to which we ought to compare, assess and design institutional arrangements in terms of their epistemic properties? Two main options are agent development and attainment of truth. The options are presented through two authoritative contemporary accounts-agent development by Robert Talisse’s understanding in Democracy and Moral Conflict and attainment of truth by David Estlund’s treatment, most prominently in Democratic Authority: A Philosophical Framework. Both options are shown to be unsatisfactory because they are subject to (...) problematic risk of suboptimal epistemic state lock-in. The ability of the social epistemic system to revise suboptimal epistemic states is argued to be the best option for a comparative standard in institutional epistemology. (shrink)

The problem of synthesis and reconciliation of the Ramanuja and Sirhindi is of vital significance and importance, and no serious student of comparative philosophy can deliberately neglect it. Epistemologically speaking, these two philosophers have been forced to tackle the same problem(s), and in solving them, their methods and hypotheses have been noticeably similar. The emphasis of this paper is to recognize, highlight, and compare the aspects valued in Ramanuja’s epistemological views with those of the Sirhindi. I will also discuss (...) the basic postulates of Ramanuja and Sirhindi’s epistemology and underline certain epistemological approaches to knowledge and justification for formulating the arguments to find out new dimensions in outlining their fundamental epistemological positions. This paper explores certain elements in the identities of these two philosophers and attempts to demonstrate a thread of continuity, especially with regard to their methods and thoughts. This paper also brings out a brief critical account of their epistemological views. (shrink)

Even as dismissive of pursuing Comparative Philosophy for achieving East-West synthesis in philosophy, the author maintains the need for “open philosophizing.” “Open philosophizing” is one characterized by dialogical openness to culturally diverse philosophical traditions and thought-patterns.

Despite its importance, the work is rather secondary in the sense that it relies, for the most part, on the Buddhist logical legacy. The first extant commentary is the Nyayavatara-vivrti of Siddharsigani.

Which epistemic value is the standard according to which we ought to compare, assess and design institutional arrangements in terms of their epistemic properties? Two main options are agent development and attainment of truth. The options are presented through two authoritative contemporary accounts-agent development by Robert Talisse?s understanding in Democracy and Moral Conflict and attainment of truth by David Estlund?s treatment, most prominently in Democratic Authority: A Philosophical Framework. Both options are shown to be unsatisfactory because they are subject to (...) problematic risk of suboptimal epistemic state lock-in. The ability of the social epistemic system to revise suboptimal epistemic states is argued to be the best option for a comparative standard in institutional epistemology. nema. (shrink)

The adoption of a comparative method in research on the thought of Mao Zedong is essential. In the past, study in this area has frequently concentrated on the thought of Mao Zedong itself and there has been no attempt at a comprehensive comparison of it within a world-wide context.

This thesis explores the epistemology and theology of a Sufi theorist Ibn al-ʿ Arabī (d. 1240) and one of the most controversial Muslim scholars Ibn Taymiyya (d. 1328) comparatively. Although scholars have long emphasized the differences between these two influential and significant figures, the purpose of this thesis is to focus on their potential similarities. The present work at the outset shows that both Ibn al-ʿ Arabī and Ibn Taymiyya regard revelation, the human intellect, and inspiration – unveiling (ilhām (...) – kashf) to be the main epistemological means for acquiring religious knowledge. However, they differ over the relative value of these means or tools. Both Ibn al-ʿ Arabī and Ibn Taymiyya place revelation at the top of the hierarchy, but after that Ibn al-ʿ Arabī places inspiration – unveiling ahead of reason while Ibn Taymiyya reverses the order. The other main subject elaborated in this thesis is the theological issue of the divine names and attributes. This subject is connected to many other theological problems, and both Ibn al-ʿ Arabī and Ibn Taymiyya pay considerable attention to it. Just as many similar approaches, ideas, and interpretations may be seen concerning their epistemological stances, it is possible to see similarities in their theological positions although there are crucial distinctions as well. The unique way of finding out this similarity is to keep in mind the existence of the duality found in the thought and expression of Ibn al-ʿ Arabī. Briefly, the main finding of the thesis is that Ibn al-ʿ Arabī and Ibn Taymiyya are more similar in their epistemologies and theologies than many scholars have thought. They are benefitting from the same epistemological means while putting them in different order. Also, they share similar theological points concerning the divine names and attributes, creation, the divine will, and the incomparability of God while expressing them through different conceptions and styles. (shrink)

This book takes a theoretical enterprise in Christian philosophy of religion and applies it to Buddhism, thus defending Buddhism and presenting it favorably in comparison. Chapters explore how the claims of both Christianity and Theravada Buddhism rest on people's experiences, so the question as to which claimants to religious knowledge are right rests on the evidential value of those experiences. The book examines mysticism and ways to understand what goes on in religious experiences, helping us to understand whether it is (...) good grounds for religious belief. The author argues that religious language in both Christian and Buddhist traditions is intelligible as factual discourse, and so reports of mystical experience are true or false. The book contends that those experiences can be fruitfully thought of as perceptual in kind and that they are therefore good prima facie grounds for religious belief, in the absence of defeating conditions. The work goes on to explore Christian and Buddhist testimony and how the likelihood of self-deception, self-delusion, imaginative elaboration and the like constitutes a defeating condition. It is shown that this defeater has less scope for operation in the Buddhist case than in the Christian case, and therefore Theravada Buddhism is better grounded. This work will appeal to students and scholars of philosophy and philosophy of religion, and those interested in the study of religious experience. (shrink)

An unprecedented and comprehensive demonstration of the numerous connections between the philosophies of Plato and Plotinus, their epistemologies, metaphysics, and ethics, including the argument that if Plotinus is a mystic, so is Plato—addressing criticisms in English scholarship to this view throughout.

The process of making ethical judgments is much more complex than studying only personal moral philosophy variables (idealism and relativism). The renewed interest in epistemic values (virtue and vice epistemology) in contemporary philosophy has shown significant relevance to understanding ethical behavior and such values may be better predictors than studying only idealism and relativism. The purpose of this exploratory study is to examine employees’ personal moral philosophies, optimism, epistemic values, and various organizational unethical practices as compared to their managers. (...) We used Rawwas’ items of epistemology in this study. The sample consisted of 262 managers and employees. The results revealed that managers were more sensitive to organizational unethical practices, scored less on epistemic vices, less on absolutism, and more on exceptionalism than employees were. However, there was no difference between managers and employees related to moderate and minor unethical organizational practices, situationism, subjectivism, optimism, and epistemic virtues. We provided discussion of the results and implications. (shrink)

This volume compares the western ideas of knowledge with the African. It aims at creating a mirror through which the western knowledge culture can look at itself through an unusual and interesting angle. The culture of Sub-Saharan Africa is the substance from which we, in this book, have tried to construe an epistemological mirror.

Indian philosophy being profoundly rich from socio-political, economical, and spiritual perspective has a lot to offer. A lot many philosophies of different Indian thinkers have been probed into for the purpose of character and national building such as that of Kautilya, Gandhi, Nehru, M.N. Roy and likewise. However, there exists a plethora of thinkers whose philosophies have been not studied systematically or have been overlooked. It is owing to this research gap, that the paper is prepared with special attention to (...) the teachings and philosophy of Swami Vivekananda who altogether gives a different perspective about life and its intricacies. This paper tends to explore the various socio-political concepts expounded by Swami Vivekananda which are relevant event today and if taken and deliberated upon seriously have the potential to resolve a lot many crises that are being faced by the Indian society. This is a qualitative study, examining the political philosophy of Swami Vivekananda through his works. The paper analyses the relevance of the philosophy in the then era as well as in the contemporary era with reference to western ideas and philosophy. A comparative approach is adopted in the paper to comprehend the differences as well as the similarities between the philosophy of western thinkers with that of Swami Vivekananda. (shrink)

In the present article, I compare Ernst Mach’s and Heinrich Gomperz’s contributions to the German-speaking positivist tradition by showing how, in trying to refound epistemology on the basis of one definite category of experiential element, namely, sensation and feeling, respectively, they each epitomized one major trend of Immanenzpositivismus. I demonstrate that, besides Mach’s “sensualist” conception of positivism – in light of which historians have tended thus far to interpret all German-speaking positivist research of that period – there also existed (...) an “affectivist” conception of positivism, which originated in Avenarius’s empiriocriticism and culminated in Gomperz’s pathempiricism. Here I aim to provide a new perspective on the history of positivism by highlighting the role played in it by psychological concerns. First, I revisit the notion of Immanenzpositivismus, the form of positivism that prevailed in both Germany and Austria between the late nineteenth and early twentieth centuries: in addition to addressing the definition of this philosophical school of thought, I discuss the issue of “pure experience”, from which the positivists tried to reinterpret the foundations of knowledge. Second, I deal with Mach’s sensation-based approach to Immanenzpositivismus by commenting on his ontological and typological analysis of the constitutive elements of experience and emphasizing the fact that his concept of Empfindung is a relatively ill-defined notion in light of contemporary psychological standards. Moreover, I show that, despite his pretense of confining his epistemological developments to the analysis of sensations, Mach did not deny the involvement of feelings in epistemology, as clearly evidenced by some passages of Erkenntnis und Irrtum. Third, I analyze Gomperz’s feeling-based conception of Immanenzpositivismus, that is, pathempiricism, by highlighting how he strove to radically refound epistemology on the basis of the most recent advances of affective psychology. Focusing on the question of language sciences, I also discuss how he considered the role of feelings in the various forms of theoretical knowledge, the only field of investigation that he revisited in detail in his unfinished book, the Weltanschauungslehre. Fourth and last, I contrast Gomperz’s with Mach’s positivist model and argue that the former is more coherent and has a higher explanatory power than the latter. In conclusion, I insist on the importance of revisiting pathempiricism within the broader framework of affective epistemology. (shrink)

There is a long tradition comparing moral knowledge to mathematical knowledge. In this paper, I discuss apparent similarities and differences between knowledge in the two areas, realistically conceived. I argue that many of these are only apparent, while others are less philosophically significant than might be thought. The picture that emerges is surprising. There are definitely differences between epistemological arguments in the two areas. However, these differences, if anything, increase the plausibility of moral realism as compared to mathematical realism. It (...) is hard to see how one might argue, on epistemological grounds, for moral antirealism while maintaining commitment to mathematical realism. But it may be possible to do the opposite. (shrink)

This is a response to the recent essay by Elizabeth M. Bucar and Aaron Stalnaker on “Comparative Religious Ethics as a Field of Study.” I clarify my earlier positions on method and virtue in comparative religious ethics and try to respond to some of the issues that Bucar and Stalnaker raise in regard to my arguments specifically and the field more generally. I argue that while we need not measure the practical impact of scholarly work in comparative (...) religious ethics purely in terms of political or social action, I nevertheless worry that defining the goals of comparative inquiry in terms of the production of bewilderment, intellectual vertigo, or skeptical questions can lead to impressionistic or therapeutic methodological norms. In a similar vein, I refine my earlier position on externalism that acknowledges the impossibility of a purely externalist approach but also notes the desirability of coming to understand others “in their own terms” prior to engaging in the process of transmutation. I also question Bucar and Stalnaker's pessimism about the potential of producing “rigorously convincing ethical theory from the lived experience of regular folk,” suggesting that perhaps we are working with different conceptions of the sociology of knowledge. Finally, I consider whether we are currently in the midst of an epistemological crisis and conclude with some reflections on the rationality of the craft of comparative religious ethics. (shrink)

This book is a comparative study of the fundamental metaphysical assumptions and their epistemological implications in Chinese and Western philosophy. The author uses a topical comparison methodology based on responses to a central topical issue to argue for commensurability in Chinese and Western metaphysics.

If the much discussed fragmentation of the West means that we can seldom hold constructive moral conversations with our near neighbors, why imagine that comparative ethics is feasible as a critical enterprise with a coherent method? How, more specifically, do we understand the relative merits of naturalism, formalism, and supernaturalism as ethical orientations? The author addresses these questions first by examining the meaning of the quoted terms, then by criticizing the inordinate optimism of most naturalisms and formalisms. The article (...) ends by briefly elaborating and defending a supernaturalist conception of Christian love. As a fruit of the Spirit, agape leaves one neither heteronomous nor autonomous, but holy. Such holiness can move one to appreciate, judiciously, cultures different from one's own. (shrink)

Indigenous cultures of North America confronted a problem of knowledge different from that of canonical European philosophy. The European problem is to identify and overcome obstacles to the perfection of knowledge as science, while the Indigenous problem is to conserve a legacy of practice fused with a territory. Complicating the difference is that one of these traditions violently colonized the other, and with colonization the Indigenous problem changes. The old problem of inter-generational stability cannot be separated from the post-colonial problem (...) of sovereignty in the land where the knowledge makes sense. I differentiate the question of the value of knowledge (Part One), and its content (Part Two). The qualities these epistemologies favor define what I call ceremonial knowledge, that is, knowledge that sustains a ceremonial community. The question of content considers the interdisciplinary research of Indigenous and Traditional Ecological Knowledge, as well as the issue of epistemic decolonization. (shrink)

This collection of essays, by Reding, in the emergent field of Sino-Hellenic studies, explores the neglected inchoative strains of rational thought in ancient China and compares them to similar themes in ancient Greek thought, right at the beginnings of philosophy in both cultures. Reding develops and defends the bold hypothesis that Greek and Chinese rational thinking are one and the same phenomenon. Rather than stressing the extreme differences between these two cultures - as most other writings on these subjects - (...) Reding looks for the parameters that have to be restored to see the similarities. Reding maintains that philosophy is like an unknown continent discovered simultaneously in both China and Greece, but from different starting-points. The book comprises seven essays moving thematically from conceptual analysis, logic and categories to epistemology and ontology, with an incursion in the field of comparative metaphorology. One of the book's main concerns is a systematic examination of the problem of linguistic relativism through many detailed examples. (shrink)

How should one understand comparisons in which neither of two alternatives is at least as good as the other? Much recent literature on comparability problems focuses on what the appropriate explanation of the phenomenon is. Is it due to vagueness or the possibility of non-conventional comparative relations such as parity? This paper argues that the discussions on how to best explain comparability problems has reached an impasse at which it is hard to make any progress. To advance the discussion (...) we suggest a new classification of comparability problems that focuses on the problems they cause for practical reasoning. (shrink)

Measuring an individual’s health states presupposes the ability to compare them. I maintain that our ability to compare quantities or magnitudes of health are severely limited. It is easier to compare values of health states, but those values are context dependent and often unreliable.

(2001). How important is truth to epistemology and knowledge? Some answers from comparative philosophy. Social Epistemology: Vol. 15, No. 4, pp. 275-283.

The Epistemological Turn of the Twentieth Century’s Legal Positivism This article analyses the essential changes in the positivist law theory from its modern origins, usually remitted to Hobbes, Bentham and Austin, to the positivism of Kelsen and Hart. It is argued that a crucial epistemological break can be noticed, revealed in the most analytic-rationalistic character of Kelsen and Hart’s elaborations, compared to the more facts-descriptive style of their predecessors. Rationalism in Kelsen and Hart may explain the conventional character of the (...) basic norm and the rule of recognition, validity only formally, and the difficulty of accounting for the formal and substantive components. The change can be associated with Kelsen and Hart’s intellectual context, particularly Hume’s ‘guillotine’, the influences of logical positivism and neo-Kantian schools. This turn should not be overlooked since it casts doubts on the usual speaking of Kelsen and Hart’s legal positivism in the descriptive sense of nineteenth-century philosophers, with relevant consequences for thinking of law. (shrink)

The aim of this paper is to examine Francis Glisson’s theory of perception insofar as it concerns the lowest class of living beings: plants. Plants have a special status, they are located between inanimate objects and animals in the hierarchy of being. Unlike the former, they are organic, but unlike the latter they are unconscious. Peculiar to Glisson is the claim that vegetative organization requires self-referential perception. In light of traditional epistemology, this claim may sound puzzling, because we tend (...) to associate self-representation with conscious thought. In order to make sense of Glisson’s self-referential, but unconscious perceptions, the first part of the paper investigates the role of perception in the vegetative process of organization. The second part is a comparative study on two ways of drawing the distinction between unconscious perceptions and conscious sensations. The first one is the Cartesian approach as outlined by Antoine Arnauld in the early 1680s, the second one is Glisson’s theory. In light of the comparison it is argued that Glisson’s is a higher order theory of sensation in which the phenomenon of consciousness requires the delimitation of the all-inclusive, self-referential nature of perception. (shrink)

This essay is a brief attempt to summarize and evaluate the contributions that "Democracy and Tradition" makes to the field of comparative ethics. It is argued that the potential impact of these contributions would be strengthened by engagement with the common morality already imbedded in international human rights norms.

ABSTRACT I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments. INTRODUCTION In contrast to the classic model of randomized-control trials, often with a large number of (...) subjects enrolled, precision medicine attempts to optimize therapeutic outcomes by focusing on the individual.[i] A recent publication highlights the strengths and weakness of both traditional evidence-based medicine and precision medicine.[ii] Plus, it outlines a tension in the shift from evidence-based medicine’s inductive reasoning style (the collection of data to postulate general theories) to precision medicine’s abductive reasoning style (the generation of an idea from the limited data available).[iii] The paper’s main example is the application of precision medicine for the treatment of cancer.[iv] I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. As the name suggests, brain-computer interfaces are a significant advancement in neurotechnology that directly connects someone’s brain to external or implanted devices.[v] Among the various kinds of brain-computer interfaces, adaptive deep brain stimulation devices require numerous personalized adjustments to their settings during the implantation and computation stages in order to provide adequate relief to patients with treatment-resistant disorders. What makes these devices unique is how adaptive deep brain stimulation integrates a sensory component to initiate the stimulation. While not commonly at the level of sophistication as self-supervising or generative large language models,[vi] they currently allow for a semi-autonomous form of neuromodulation. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments.[vii] ANALYSIS I. The State of Precision Medicine in Oncology and the Epistemological Shift While a thorough overview of precision medicine for the treatment of cancer is beyond the scope of this article, its practice can be roughly summarized as identifying clinically significant characteristics a patient possesses (e.g., genetic traits) to land on a specialized treatment option that, theoretically, should benefit the patient the most.[viii] However, in such a practice of stratification patients fall into smaller and smaller populations and the quality of evidence that can be applied to anyone outside these decreases in turn.[ix] As inductive logic helps to articulate, the greater the number of patients that respond to a particular therapy the higher the probability of its efficacy. By straying from this logical framework, precision medicine opens the treatment of cancer to more uncertainty about the validity of these approaches to the resulting disease subcategories.[x] Thus, while contemporary medical practices explicitly describe some treatments as “personalized”, they ought not be viewed as inherently better founded than other therapies.[xi] A relevant contemporary case of precision medicine out of Norway focuses on the care of a patient with cancer between the ventricles of the heart and esophagus, which had failed to respond to the standard regimen of therapies over four years.[xii] In a last-ditch effort, the patient elected to pay out-of-pocket for an experimental immunotherapy (nivolumab) at a private hospital. He experienced marked improvements and a reduction in the size of the tumor. Understandably, the patient tried to pursue further rounds of nivolumab at a public hospital. However, the hospital initially declined to pay for it given the “lack of evidence from randomised clinical trials for this drug relating to this [patient’s] condition.”[xiii] In rebuttal to this claim, the patient countered that he was actually similar to a subpopulation of patients who responded in “open‐label, single arm, phase 2 studies on another immune therapy drug” (pembrolizumab).[xiv] Given this interpretation of the prior studies and the patient’s response, further rounds of nivolumab were approved. Had the patient not had improvements in the tumor’s size following a round of nivolumab, then pembrolizumab’s prior empirical evidence in isolation would have been insufficient, inductively speaking, to justify his continued use of nivolumab.[xv] The case demonstrates a shift in reasoning from the traditional induction to abduction. The phenomenon of ‘cancer improvement’ is considered causally linked to nivolumab and its underlying physiological mechanisms.[xvi] However, “the weakness of abductions is that there may always be some other better, unknown explanation for an effect. The patient may for example belong to a special subgroup that spontaneously improves, or the change may be a placebo effect. This does not mean, however, that abductive inferences cannot be strong or reasonable, in the sense that they can make a conclusion probable.”[xvii] To demonstrate the limitations of relying on the abductive standard in isolation, commentators have pointed out that side effects in precision medicine are hard to rule out as being related to the initial intervention itself unless trends from a group of patients are taken into consideration.[xviii] As artificial intelligence (AI) assists the development of precision medicine for oncology, this uncertainty ought to be taken into consideration. The implementation of AI has been crucial to the development of precision medicine by providing a way to combine large patient datasets or a single patient with a large number of unique variables with machine learning to recommend matches based on statistics and probability of success upon which practitioners can base medical recommendations.[xix] The AI is usually not establishing a causal relationship[xx] – it is predicting. So, as AI bleeds into medical devices, like brain-computer interfaces, the same cautions about using abductive reasoning alone should be carried over. II. Responsive Neurostimulation, AI, and Personalized Medicine Like precision medicine in cancer treatment, computer-brain interface technology similarly focuses on the individual patient through personalized settings. In order to properly expose the intersection of AI, precision medicine, abductive reasoning, and implantable neurotechnologies, the descriptions of adaptive deep brain stimulation systems need to deepen.[xxi] As a broad summary of adaptive deep brain stimulation, to provide a patient with the therapeutic stimulation, a neural signal, typically referred to as a local field potential,[xxii] must first be detected and then interpreted by the device. The main adaptive deep brain stimulation device with premarket approval, the NeuroPace Responsive Neurostimulation system, is used to treat epilepsy by detecting and storing “programmer-defined phenomena.”[xxiii] Providers can optimize the detection settings of the device to align with the patient’s unique electrographic seizures as well as personalize the reacting stimulation’s parameters.[xxiv] The provider adjusts the technology based on trial and error. One day machine learning algorithms will be able to regularly aid this process in myriad ways, such as by identifying the specific stimulation settings a patient may respond to ahead of time based on their electrophysiological signatures.[xxv] Either way, with AI or programmers, adaptive neurostimulation technologies are individualized and therefore operate in line with precision medicine rather than standard treatments based on large clinical trials. Contemporary neurostimulation devices are not usually sophisticated enough to be prominent in AI discussions where the topics of neural networks, deep learning, generative models, and self-attention dominate the conversation. However, implantable high-density electrocorticography arrays (a much more sensitive version than adaptive deep brain stimulation systems use) have been used in combination with neural networks to help patients with neurologic deficits from a prior stroke “speak” through a virtual avatar.[xxvi] In some experimental situations, algorithms are optimizing stimulation parameters with increasing levels of independence.[xxvii] An example of neurostimulation that is analogous to the use of nivolumab in Norway surrounds a patient in the United States who was experiencing both treatment-resistant OCD and temporal lobe epilepsy.[xxviii]Given the refractory nature of her epilepsy, implantation of an adaptive deep brain stimulation system was indicated. As a form of experimental therapy, her treatment-resistant OCD was also indicated for the off-label use of an adaptive deep brain stimulation set-up. Another deep brain stimulation lead, other than the one implanted for epilepsy, was placed in the patient’s right nucleus accumbens and ventral pallidum region given the correlation these nuclei had with OCD symptoms in prior research. Following this, the patient underwent “1) ambulatory, patient-initiated magnet-swipe storage of data during moments of obsessive thoughts; (2) lab-based, naturalistic provocation of OCD-related distress (naturalistic provocation task); and (3) lab-based, VR [virtual reality] provocation of OCD-related distress (VR provocation task).”[xxix] Such signals were used to identify when to deliver the therapeutic stimulation in order to counter the OCD symptoms. Thankfully, following the procedure and calibration the patient exhibited marked improvements in their OCD symptoms and recently shared her results publicly.[xxx] In both cases, there is a similar level of abductive justification for the efficacy of the delivered therapy. In the case study in which the patient was treated with adaptive deep brain stimulation, they at least had their neural activity tested in various settings to determine the optimum parameters for treatment to avoid them being based on guesswork. Additionally, the adaptive deep brain stimulation lead was already placed before the calibration trials were conducted, meaning that the patient had already taken on the bulk of the procedural risk before the efficacy could be determined. Such an efficacy test could have been replicated in the first patient’s cancer treatment, had it been biopsied and tested against the remaining immunotherapies in vitro. Yet, in the case of cancer with few options, one previous dose of a drug that appeared to work on the patient may justify further doses. However, as the Norwegian case presents, corroboration with known responses to a similar drug (from a clinical trial) could be helpful to validate the treatment strategy. (It should be noted that both patients were resigned to these last resort options regardless of the efficacy of treatment.) There are some elements of inductive logic seen with adaptive deep brain stimulation research in general. For example, abductively the focus could be that patient X’s stimulation parameters are different from patient Y’s and patient Z’s. In contrast, when grouped as subjects who obtained personalized stimulation, patients X, Y, and Z demonstrate an inductive aspect to this approach’s safety and/or efficacy. The OCD case holds plenty of abductive characteristics in line with precision medicine’s approach to treating cancer and as more individuals try the method, there will be additional data. With the gradual integration of AI into brain-computer interfaces in the name of efficacy, this reliance on abduction will continue, if not grow, over time. Moving forward, if a responsive deep brain stimulation treatment is novel and individualized (like the dose of nivolumab) and there is some other suggestion of efficacy (like clinical similarities to other patients in the literature), then it may justify insurance coverage for the investigative intervention, absent other unrelated reasons to deny it. III. Ethical Implications and Next Steps While AI’s use in oncology and neurology is not yet as prominent as its use in other fields (e.g., radiology), it appears to be on the horizon for both.[xxxi] AI can be found in both the functioning of the neurotechnologies as well as the implementation of precision medicine. The increasing use of AI may serve to further individualize both oncologic and neurological therapies. Given these implications and the handful of publications cited in this article, it is important to have a nuanced evaluation of how these treatments, which heavily rely on abductive justification, ought to be managed. The just use an abductive approach may be difficult as AI infused precision medicine is further pursued. At baseline, such technology relies on a level of advanced technology literacy among the general public and could exclude populations who lack access to basic technological infrastructure or know-how from participation.[xxxii] Even among nations with adequate infrastructure, as more patients seek out implantable neurotechnologies, which require robust healthcare resources, the market will favor patient populations that can afford this complex care.[xxxiii] If patients already have the means to pay for an initial dose/use of a precision medicine product out of pocket, should insurance providers be required to cover subsequent treatments?[xxxiv] That is, if a first dose of a cancer drug or a deep brain stimulator over its initial battery life is successful, patients may feel justified in having the costs of further treatments covered. The Norwegian patient’s experience implies there is a precedent for the idea that some public insurance companies ought to cover successful cancer therapies, however, insurance companies may not all see themselves as obligated to cover neurotechnologies that rely on personalized settings or that are based on precision/abductive research more than on clinical trials. CONCLUSION The fact that the cases outlined above rely on abductive style of reasoning implies that there may not be as strong a justification for coverage by insurance, as they are both experimental and individualized, when compared to the more traditional large clinical trials in which groups have the same or a standardized protocol (settings/doses). If a study is examining the efficacy of a treatment with a large cohort of patients or with different experimental groups/phases, insurance companies may conclude that the resulting symptom improvements are more likely to be coming from the devices themselves. A preference for inductive justification may take priority when ruling in favor of funding someone’s continued use of an implantable neurostimulator. There are further nuances to this discussion surrounding the classifications of these interventions as research versus clinical care that warrant future exploration, since such a distinction is more of a scale[xxxv] than binary and could have significant impacts on the “right-to-try” approach to experimental therapies in the United States.[xxxvi] Namely, given the inherent limitations of conducting large cohort trials for deep brain stimulation interventions on patients with neuropsychiatric disorders, surgically innovative frameworks that blend abductive and inductive methodologies, like with sham stimulation phases, have traditionally been used.[xxxvii] Similarly, for adaptive brain-computer interface systems, if there are no large clinical trials and instead only publications that demonstrate that something similar worked for someone else, then, in addition to the evidence that the first treatment/dose worked for the patient in question, the balance of reasoning would be valid and arguably justify insurance coverage. As precision approaches to neurotechnology become more common, frameworks for evaluating efficacy will be crucial both for insurance coverage and for clinical decision making. ACKNOWLEDGEMENT This article was originally written as an assignment for Dr. Francis Shen’s “Bioethics & AI” course at Harvard’s Center for Bioethics. I would like to thank Dr. Shen for his comments as well as my colleagues in the Lázaro-Muñoz Lab for their feedback. - [i] Jonathan Kimmelman and Ian Tannock, “The Paradox of Precision Medicine,” Nature Reviews. Clinical Oncology 15, no. 6 (June 2018): 341–42, https://doi.org/10.1038/s41571-018-0016-0. [ii] Henrik Vogt and Bjørn Hofmann, “How Precision Medicine Changes Medical Epistemology: A Formative Case from Norway,” Journal of Evaluation in Clinical Practice 28, no. 6 (December 2022): 1205–12, https://doi.org/10.1111/jep.13649. [iii] David Barrett and Ahtisham Younas, “Induction, Deduction and Abduction,” Evidence-Based Nursing 27, no. 1 (January 1, 2024): 6–7, https://doi.org/10.1136/ebnurs-2023-103873. [iv] Vogt and Hofmann, “How Precision Medicine Changes Medical Epistemology,” 1208. [v] Wireko Andrew Awuah et al., “Bridging Minds and Machines: The Recent Advances of Brain-Computer Interfaces in Neurological and Neurosurgical Applications,” World Neurosurgery, May 22, 2024, S1878-8750(24)00867-2, https://doi.org/10.1016/j.wneu.2024.05.104. [vi] Mark Riedl, “A Very Gentle Introduction to Large Language Models without the Hype,” Medium (blog), May 25, 2023, https://mark-riedl.medium.com/a-very-gentle-introduction-to-large-language-models-without-the-hype-5 f67941fa59e. [vii] David E. Burdette and Barbara E. Swartz, “Chapter 4 - Responsive Neurostimulation,” in Neurostimulation for Epilepsy, ed. Vikram R. Rao (Academic Press, 2023), 97–132, https://doi.org/10.1016/B978-0-323-91702-5.00002-5. [viii] Kimmelman and Tannock, 2018. [ix] Kimmelman and Tannock, 2018. [x] Simon Lohse, “Mapping Uncertainty in Precision Medicine: A Systematic Scoping Review,” Journal of Evaluation in Clinical Practice 29, no. 3 (April 2023): 554–64, https://doi.org/10.1111/jep.13789. [xi] Kimmelman and Tannock, “The Paradox of Precision Medicine.” [xii] Vogt and Hofmann, 1206. [xiii] Vogt and Hofmann, 1206. [xiv] Vogt and Hofmann, 1206. [xv] Vogt and Hofmann, 1207. [xvi] Vogt and Hofmann, 1207. [xvii] Vogt and Hofmann, 1207. [xviii] Vogt and Hofmann, 1210. [xix] Mehar Sahu et al., “Chapter Three - Artificial Intelligence and Machine Learning in Precision Medicine: A Paradigm Shift in Big Data Analysis,” in Progress in Molecular Biology and Translational Science, ed. David B. Teplow, vol. 190, 1 vols., Precision Medicine (Academic Press, 2022), 57–100, https://doi.org/10.1016/bs.pmbts.2022.03.002. [xx] Stefan Feuerriegel et al., “Causal Machine Learning for Predicting Treatment Outcomes,” Nature Medicine 30, no. 4 (April 2024): 958–68, https://doi.org/10.1038/s41591-024-02902-1. [xxi] Sunderland Baker et al., “Ethical Considerations in Closed Loop Deep Brain Stimulation,” Deep Brain Stimulation 3 (October 1, 2023): 8–15, https://doi.org/10.1016/j.jdbs.2023.11.001. [xxii] David Haslacher et al., “AI for Brain-Computer Interfaces,” 2024, 7, https://doi.org/10.1016/bs.dnb.2024.02.003. [xxiii] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 103–4; “Premarket Approval (PMA),” https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P100026. [xxiv] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 104. [xxv] Burdette and Swartz, 126. [xxvi] Sean L. Metzger et al., “A High-Performance Neuroprosthesis for Speech Decoding and Avatar Control,” Nature 620, no. 7976 (August 2023): 1037–46, https://doi.org/10.1038/s41586-023-06443-4. [xxvii] Hao Fang and Yuxiao Yang, “Predictive Neuromodulation of Cingulo-Frontal Neural Dynamics in Major Depressive Disorder Using a Brain-Computer Interface System: A Simulation Study,” Frontiers in Computational Neuroscience 17 (March 6, 2023), https://doi.org/10.3389/fncom.2023.1119685; Mahsa Malekmohammadi et al., “Kinematic Adaptive Deep Brain Stimulation for Resting Tremor in Parkinson’s Disease,” Movement Disorders 31, no. 3 (2016): 426–28, https://doi.org/10.1002/mds.26482. [xxviii] Young-Hoon Nho et al., “Responsive Deep Brain Stimulation Guided by Ventral Striatal Electrophysiology of Obsession Durably Ameliorates Compulsion,” Neuron 0, no. 0 (October 20, 2023), https://doi.org/10.1016/j.neuron.2023.09.034. [xxix] Nho et al. [xxx] Nho et al.; Erik Robinson, “Brain Implant at OHSU Successfully Controls Both Seizures and OCD,” OHSU News, accessed March 3, 2024, https://news.ohsu.edu/2023/10/25/brain-implant-at-ohsu-successfully-controls-both-seizures-and-ocd. [xxxi] Awuah et al., “Bridging Minds and Machines”; Haslacher et al., “AI for Brain-Computer Interfaces.” [xxxii] Awuah et al., “Bridging Minds and Machines.” [xxxiii] Sara Green, Barbara Prainsack, and Maya Sabatello, “The Roots of (in)Equity in Precision Medicine: Gaps in the Discourse,” Personalized Medicine 21, no. 1 (January 2024): 5–9, https://doi.org/10.2217/pme-2023-0097. [xxxiv] Green, Prainsack, and Sabatello, 7. [xxxv] Robyn Bluhm and Kirstin Borgerson, “An Epistemic Argument for Research-Practice Integration in Medicine,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 43, no. 4 (July 9, 2018): 469–84, https://doi.org/10.1093/jmp/jhy009. [xxxvi] Vijay Mahant, “‘Right-to-Try’ Experimental Drugs: An Overview,” Journal of Translational Medicine 18 (June 23, 2020): 253, https://doi.org/10.1186/s12967-020-02427-4. [xxxvii] Michael S. Okun et al., “Deep Brain Stimulation in the Internal Capsule and Nucleus Accumbens Region: Responses Observed during Active and Sham Programming,” Journal of Neurology, Neurosurgery & Psychiatry 78, no. 3 (March 1, 2007): 310–14, https://doi.org/10.1136/jnnp.2006.095315. (shrink)

This is the first title in the Key Themes in Ancient Philosophy series, which provides concise books, written by major scholars and accessible to non-specialists, on important themes in ancient philosophy which remain of philosophical interest today. In this book, Professor Gerson explores ancient accounts of the nature of knowledge and belief from the Presocratics up to the Platonists of late antiquity. He argues that ancient philosophers generally held a naturalistic view of knowledge as well as of belief. Hence, knowledge (...) was not viewed as a stipulated or semantically determined type of belief but was rather a real or objectively determinable achievement. In fact, its attainment was identical with the highest possible cognitive achievement, namely wisdom. It was this naturalistic view of knowledge at which the ancient Skeptics took aim. The book concludes by comparing the ancient naturalistic epistemology with some contemporary versions. (shrink)

Ayn Rand’s Objectivist epistemology is the foundation of an impressive, comprehensive, and integrated system of political philosophy, psychology, art, and literature. Friedrich Hayek’s operational system of epistemology and his analysis of the psychology of perception (presented primarily in The Sensory Order) is not as clearly integrated with his economics and political philosophy—and many have debated their consistency with one another. This paper engages in a comparative analysis of Rand’s and Hayek’s epistemology.

The article examines negotiations as dialogues concerning conflicting interests among participants. It argues that negotiations represent the primary and most socially significant type of dialogue. This is evidenced by the disproportionate volume of research dedicated to negotiations compared to other forms of dialogue, as well as the multidisciplinary approach to their study. The purpose of the article is to investigate negotiations through the lens of epistemology, one of the disciplines involved in their analysis. The author contends that negotiations are (...) epistemological processes governed by epistemological principles. To elucidate these principles, the article explicates key categories serving as research instruments, primarily focusing on the concepts of “negotiation” and “interest.” The relationship between “interest” and related concepts such as “desire,” “need,” and “benefit” is explored. There are two types of dialogue: those concerning the veracity of descriptions and those focused on the rationality of prescriptions. The article elucidates the distinct nature of negotiations as dialogues about prescriptions. The article also underscores the importance of the categories of “research” and “communication” in understanding the nature of negotiations. Since negotiations are fundamentally a form of communication, the examination of conflicting interests and the search for solutions to these conflicts do not fall within the negotiation process itself. These tasks are addressed prior to negotiations, during the research phase. The purpose of negotiations is to discuss and either accept or reject the outcomes of these preliminary investigations, particularly pre-drafted agreements on resolving conflicts of interest. Based on this framework, the article explores the epistemological mechanisms underlying negotiations related to the division, consolidation, and exchange of benefits. Additionally, the Harvard Negotiation Program, which seeks to transform negotiations from a confrontation of positions into a collaborative search for a shared solution, is subjected to epistemological analysis. The role of empathy in facilitating this transformation is also discussed. In conclusion, it is argued that an epistemological analysis of negotiations not only deepens our understanding of their nature as a distinct form of communication but also offers tools for enhancing negotiation practices, promoting the resolution of conflicts of divergent interests in various social conflicts without resorting to physical confrontation. (shrink)

Epistemological probability is the kind of probability relative to a body of evidence. Many philosophers, including Henry Kyburg and Roderick Chisholm, hold that all epistemological probabilities reflect a relation between an evidential body of propositions and other propositions. But this article argues that some epistemological probabilities for empirical propositions must be relative to non-propositional evidence, specifically the contents of non-propositional perceptual states. In doing so, the article distinguishes between internalism and externalism regarding epistemological probability, and argues for a version of (...) awareness internalism. The article draws three main concluding lessons. First, epistemological probability is not to be identified with the sort of objective, experience-independent probability that is familiar from statistical and propensity interpretations of probability. Second, it is doubtful that epistemological probability is measurable, in any useful way, by real numbers, even if it admits of comparative assessments. Third, contrary to the familiar claim of C. I. Lewis, epistemological probability should not be viewed as requiring a basis of certainty. (shrink)