Large scale DNA-mutation screening in patients with hereditary retinal diseases greatly enhances our knowledge about retinal function and diseases. Scientists, clinicians, patients, and families involved with retinal disorders may directly benefit from these developments. However, certain aspects of this expanding knowledge, such as the correlation between genotype and phenotype, may be much more complicated than we expect at present.

We develop the concept of a volitional disability as an aid in understanding those patients who behave in ways that are harmful to themselves in spite of their desire to do otherwise. Using this concept enables us to describe their behavior as intentional but ‘unvoluntary’. We demonstrate the clinical reality of such behavior by giving clinical examples of the behavior of those with phobic, compulsive, and addictive disorders. We then attempt to show how some kinds of self-harming behavior of noncompliant (...) patients are similar to phobic and compulsive behavior. We propose use of the concept of volitional disability to make it easier for physicians to work with these noncompliant patients and thus to improve their ability to provide better care for them. (shrink)

Episodic representations can be entertained either as “remembered” or “imagined”—as outcomes of experience or as simulations of such experience. Here, we argue that this feature is the product of a dedicated cognitive function: the metacognitive capacity to determine the mnemicity of mental event simulations. We argue that mnemicity attribution should be distinguished from other metacognitive operations (such as reality monitoring) and propose that this attribution is a “cognitive gadget”—a distinctively human ability made possible by cultural learning. Cultural learning is a (...) type of social learning in which traits are inherited through social interaction. In the case of mnemicity, one culturally learns to discriminate metacognitive “feelings of remembering” from other perceptual, emotional, action-related, and metacognitive feelings; to interpret feelings of remembering as indicators of memory rather than imagination; and to broadcast the interpreted feelings in culture- and context-specific ways, such as “I was there” or “I witnessed it myself.” We review evidence from the literature on memory development and scaffolding, metacognitive learning and teaching, as well as cross-cultural psychology in support of this view before pointing out various open questions about the nature and development of mnemicity highlighted by our account. (shrink)

We remember in social contexts. We reminisce about the past together, collaborate to remember shared experiences, and, even when we are alone, we remember in the context of our communities and cultures. Taking an interdisciplinary approach throughout, this text comprehensively covers collaborative remembering across the fields of developmental psychology, cognitive psychology, social psychology, discourse processing, philosophy, neuropsychology, design, and media studies. It highlights points ofoverlap and contrast across the many disciplinary perspectives and, with its sections on "Approaches of Collaborative Remembering" (...) and "Applications of Collaborative Remembering", also connects basic and applied research.Written with late-stage undergraduates and early-stage graduates in mind, the book is also a valuable tool for memory specialists and academics in the fields of psychology, cognitive science and philosophy who are interested in collaborative memory research. (shrink)

Background: Older, frail patients with multimorbidity are at an especially high risk for disease severity and death from COVID-19. The social restrictions proved challenging for the residents, their relatives, and the care staff. While these restrictions clearly impacted daily life in Norwegian nursing homes, knowledge about how the pandemic influenced nursing practice is sparse. Aim: The aim of the study was to illuminate ethical difficult situations experienced by Norwegian nurses working in nursing homes during the COVID-19 pandemic. Research design and (...) participants: The research design involved semistructured individual interviews conducted with 15 nurses working in 8 nursing homes in 3 health regions in Norway, within both urban and rural areas. Ethical considerations: Oral and written information about the study was provided before the participants gave their written consent. The transcribed interviews were de-identified. The study was approved by the Norwegian Centre for Research Data. Findings: Four ethical difficult situations were identified: (a) turning the nursing home into a prison; (b) using medication to maintain peace and order; (c) being left alone with the responsibility; and (d) s. impact on decision-making. Conclusions: The nurses’ ethical challenges were intertwined with external factors, such as national and local guidelines, and the nurses’ own internalized factors, which were connected to their subjective professionality. This duality inflicted emotional distress and gave nurses few opportunities to perform nursing in a professionally sound and safe manner. (shrink)

As a celebration of theTractatus100th anniversary it might be worth revisiting its relation to the later writings. From the former to the latter, David Pears recalls that “everyone is aware of the holistic character of Wittgenstein’s later philosophy, but it is not so well known that it was already beginning to establish itself in theTractatus” (The False Prison, 1987). From the latter to the former, Stephen Hilmy’s (The Later Wittgenstein, 1987) extensive study of theNachlasshas helped removing classical misconceptions such as (...) Hintikka’s claim that “Wittgenstein in thePhilosophical Investigationsalmost completely gave up the calculus analogy.” Hilmy points out that even in theInvestigationsone finds the use of the calculus/game paradigm to the understanding of language, such as “in operating with the word” (Part I, §559) and “it plays a different part in the calculus”. Hilmy also quotes from a late (1946) unpublished manuscript (MS 130) “this sentence has use in the calculus of language”, which seems to be compatible with “asking whether and how a proposition can be verified is only a particular way of asking ‘How do you mean?’” Central in this back and forth there is an aspect which seems to deserve attention in the discussion of a semantics for the language of mathematics which might be based on (normalisation of) proofs and/or Hintikka/Lorenzen game-dialogue: the explication of consequences. Such a discussion is substantially supported by the use of the open and searchableThe Wittgenstein Archives at the University of Bergen. These findings are framed within the discussion of the meaning of logical constants in the context of natural deduction style rules of inference. (shrink)

In this position paper, we describe a number of methodological and philosophical challenges that arose within our interdisciplinary Digital Humanities project CatVis, which is a collaboration between applied geometric algorithms and visualization researchers, data scientists working at OCLC, and philosophers who have a strong interest in the methodological foundations of visualization research. The challenges we describe concern aspects of one single epistemic need: that of methodologically securing (an increase in) trust in visualizations. We discuss the lack of ground truths in (...) the (digital) humanities and argue that trust in visualizations requires that we evaluate visualizations on the basis of ground truths that humanities scholars themselves create. We further argue that trust in visualizations requires that a visualization provides provable guarantees on the faithfulness of the visual representation and that we must clearly communicate to the users which part of the visualization can be trusted and how much. Finally, we discuss transparency and accessibility in visualization research and provide measures for securing transparency and accessibility. (shrink)

Recent scholarship emphasizes the scaffolding role of language for cognition. Language, it is claimed, is a cognition-enhancing niche ( Clark, 2006 ), a programming tool for cognition ( Lupyan and Bergen, 2016 ), even neuroenhancement ( Dove, 2019 ) and augments cognitive functions such as memory, categorization, cognitive control, and meta-cognitive abilities (“thinking about thinking”). Yet, the notion that language enhances or augments cognition, and in particular, cognitive control does not easily fit in with embodied approaches to language processing, (...) or so we will argue. Accounts aiming to explain how language enhances various cognitive functions often employ a notion of abstract representation. Yet, embodied approaches to language processing have it that language processing crucially, according to some accounts even exclusively, involves embodied, modality-specific, i.e., non-abstract representations. In coming to understand a particular phrase or sentence, a prior experience has to be simulated or reenacted. The representation thus activated is embodied (modality-specific) as sensorimotor regions of the brain are thereby recruited. In this paper, we will first discuss the notion of representation, clarify what it takes for a representation to be embodied or abstract, and distinguish between conceptual and (other) linguistic representations. We will then put forward a characterization of cognitive control and examine its representational infrastructure. The remainder of the paper will be devoted to arguing that language augments cognitive control. To that end, we will draw on two lines of research, which investigate how language augments cognitive control: (i) research on the availability of linguistic labels and (ii) research on the active usage of a linguistic code, specifically, in inner speech. Eventually, we will argue that the cognition-enhancing capacity of language can be explained once we assume that it provides us with (a) abstract, non-embodied representations and with (b) abstract, sparse linguistic representations that may serve as easy-to-manipulate placeholders for fully embodied or otherwise more detailed representations. (shrink)

A new criterion is introduced for judging the suitability of various fuzzy logics for practical uncertain reasoning in a probabilistic world and the relationship of this criterion to several established criteria, and its consequences for truth functional belief, are investigated.

To describe the content of practice guidelines on euthanasia and assisted suicide (EAS) and to compare differences between settings and guidelines developed before or after enactment of the euthanasia law in 2002 by means of a content analysis. Most guidelines stated that the attending physician is responsible for the decision to grant or refuse an EAS request. Due care criteria were described in the majority of guidelines, but aspects relevant for assessing these criteria were not always described. Half of the (...) guidelines described the role of the nurse in the performance of euthanasia. Compared with hospital guidelines, nursing home guidelines were more often stricter than the law in excluding patients with dementia (30% vs 4%) and incompetent patients (25% vs 4%). As from 2002, the guidelines were less strict in categorically excluding patients groups (32% vs 64%) and in particular incompetent patients (10% vs 29%). Healthcare institutions should accurately state the boundaries of the law, also when they prefer to set stricter boundaries for their own institution. Only then can guidelines provide adequate support for physicians and nurses in the difficult EAS decision-making process. (shrink)

Background: Legislation on physician-assisted suicide is being considered in a number of states since the passage of the Oregon Death With Dignity Act in 1994. Opinion assessment surveys have historically assessed particular subsets of physicians.Objective: To determine variables predictive of physicians’ opinions on PAS in a rural state, Vermont, USA.Design: Cross-sectional mailing survey.Participants: 1052 physicians licensed by the state of Vermont.Results: Of the respondents, 38.2% believed PAS should be legalised, 16.0% believed it should be prohibited and 26.0% believed it should (...) not be legislated. 15.7% were undecided. Males were more likely than females to favour legalisation . Physicians who did not care for patients through the end of life were significantly more likely to favour legalisation of PAS than physicians who do care for patients with terminal illness . 30% of the respondents had experienced a request for assistance with suicide.Conclusions: Vermont physicians’ opinions on the legalisation of PAS is sharply polarised. Patient autonomy was a factor strongly associated with opinions in favour of legalisation, whereas the sanctity of the doctor–patient relationship was strongly associated with opinions in favour of not legislating PAS. Those in favour of making PAS illegal overwhelmingly cited moral and ethical beliefs as factors in their opinion. Although opinions on legalisation appear to be based on firmly held beliefs, approximately half of Vermont physicians who responded to the survey agree that there is a need for more education in palliative care and pain management. (shrink)

The physician charter on medical professionalism creates standards of ethical behaviour for physicians and has been endorsed by professional organisations worldwide. It is based on the cardinal principles of the primacy of patient welfare, patient autonomy, and social welfare. There has been little discussion in the bioethics community of the doctrine of the charter and none from a Jewish ethical perspective. In this essay the authors discuss the obligations of the charter from a Jewish ethical viewpoint and call on other (...) cultures to develop their own unique perspectives on this important document. (shrink)