Next SectionBecause of the radically incarnational nature of the Christian understanding of ethics and bioethics, according to Kierkegaard, there has always been an infinite gulf between Christian bioethics and secular bioethics. However, the process of the secularization of the public square has made this gulf more apparent and salient for the current ethical debates in biomedicine and the culture more generally.

Primary progressive aphasia is a clinical syndrome in which patients progressively lose speech and language abilities. Three variants are recognized: logopenic, associated with phonology and/or short-term verbal memory deficits accompanied by left temporo-parietal atrophy; semantic, associated with semantic deficits and anterior temporal lobe atrophy; non-fluent associated with grammar and/or speech-motor deficits and inferior frontal gyrus atrophy. Here, we set out to investigate whether the three variants of PPA can be dissociated based on error patterns in a single language task. We (...) recruited 21 lvPPA, 28 svPPA, and 24 nfvPPA patients, together with 31 healthy controls, and analyzed their performance on an auditory noun-to-verb generation task, which requires auditory analysis of the input, access to and selection of relevant lexical and semantic knowledge, as well as preparation and execution of speech. Task accuracy differed across the three variants and controls, with lvPPA and nfvPPA having the lowest and highest accuracy, respectively. Critically, machine learning analysis of the different error types yielded above-chance classification of patients into their corresponding group. An analysis of the error types revealed clear variant-specific effects: lvPPA patients produced the highest percentage of “not-a-verb” responses and the highest number of semantically related nouns ; in contrast, svPPA patients produced the highest percentage of “unrelated verb” responses and the highest number of light verbs. Taken together, our findings indicate that error patterns in an auditory verb generation task are associated with the breakdown of different neurocognitive mechanisms across PPA variants. Specifically, they corroborate the link between temporo-parietal regions with lexical processing, as well as ATL with semantic processes. These findings illustrate how the analysis of pattern of responses can help PPA phenotyping and heighten diagnostic sensitivity, while providing insights on the neural correlates of different components of language. (shrink)

Whenever health care reform is debated, the state of the medical professional liability system in the United States re-emerges as an issue of importance. What exactly is broken with the MPL system and what the implications are is a point of contention among different stakeholder groups. Recent data demonstrate that medical liability premiums have been improving in recent years and the majority of premiums remained flat in 2010. General agreement still exists, however, that medical professional liability insurance premiums have become (...) unaffordable for many physicians, and coverage has become less available, especially for certain medical specialties and in specific areas of the country.Multiple factors go into the determination of medical professional liability insurance premiums including return on investments, reinsurance costs, claims frequency, average amount paid out on malpractice claims, defense expenses, and administrative costs such as underwriting expense. (shrink)

(No abstract is available for this citation).

Objective: There are benefits and risks of giving patients more granular control of their personal health information in electronic health record (EHR) systems. When designing EHR systems and policies, informaticists and system developers must balance these benefits and risks. Ethical considerations should be an explicit part of this balancing. Our objective was to develop a structured ethics framework to accomplish this. -/- Methods: We reviewed existing literature on the ethical and policy issues, developed an ethics framework called a “Points to (...) Consider” (P2C) document, and convened a national expert panel to review and critique the P2C. -/- Results: We developed the P2C to aid informaticists designing an advanced query tool for an electronic health record (EHR) system in Indianapolis. The P2C consists of six questions (“Points”) that frame important ethical issues, apply accepted principles of bioethics and Fair Information Practices, comment on how questions might be answered, and address implications for patient care. -/- Discussion: The P2C is intended to clarify whatis at stake when designers try to accommodate potentially competing ethical commitments and logistical realities. The P2C was developed to guide informaticists who were designing a query tool in an existing EHR that would permit patient granular control. While consideration of ethical issues is coming to the forefront of medical informatics design and development practices, more reflection is needed to facilitate optimal collaboration between designers and ethicists. This report contributes to that discussion. (shrink)

The American conservative movement is a force of anti-reflexivity insofar as it attacks two key elements of reflexive modernization: the environmental movement and environmental impact science. Learning from its mistakes in overtly attacking environmental regulations in the early 1980s, this counter-movement has subsequently exercised a more subtle form of power characterized by non-decision-making. We examine the conservative movement’s efforts to undermine climate science and policy in the USA over the last two decades by using this second dimension of power. The (...) conservative movement has employed four non-decision-making techniques to challenge the legitimacy of climate science and prevent progress in policy-making. We argue that reflexive modernization scholars should focus more attention on similar forces of anti-reflexivity that continue to shape the overall direction of our social, political and economic order, and the life chances of many citizens. Indeed, better understanding of the forces and effectiveness of anti-reflexivity may very well be crucial for societal resilience and adaptation, especially in the face of global environmental problems like climate change. (shrink)

Stem cell science, using both embryonic and a variety of tissue-specific stem cells, is advancing rapidly and offers promise to improve medical care in the future. Yet, with the notable exception of hematopoietic stem cell transplantation, a long-established approach to treating certain cancers of the blood system, this promise is long term and most stem cell research focuses on basic scientific questions or the collection of pre-clinical data. Although some clinical trials are underway, most are focused on safety, and novel (...) effective therapy is likely a long way off. Despite the preliminary nature of most stem cell research, however, numerous clinics around the world offer stem cell “therapies” to patients today outside the context of a clinical trial. Although the number of patients who have received these stem cell-based interventions is unknown, anecdotal reports suggest a substantial population of patients is willing to try them, despite unresolved questions about their safety and efficacy. (shrink)

Despite advances in medical knowledge regarding pain management, pain continues to be significantly undertreated in the United States. There are many drug and nondrug treatments, but the use of controlled substances, particularly the opioid analgesics, is universally accepted for the treatment of pain from cancer. Although opioid analgesics are safe and effective in treating chronic pain, there is continued research and discussion about patient selection and long-term effects. A number of barriers in the health care and drug regulatory systems account (...) for the gap between what is known about pain management and what is practiced. Among the barriers are physicians’ fears of being disciplined by state regulatory boards for inappropriate prescribing.State medical boards are in a unique position not only to address physicians’ concerns about being investigated, but also to encourage pain management. Prior to 1989, a few state medical boards had policies relating to controlled substances or pain. Subsequently, state medical boards began adopting policies regarding the prescribing of opioids for the treatment of pain; many of these specifically addressed physicians’ fear of regulatory scrutiny. (shrink)

Background Social media and Internet technologies present several emerging and ill-explored issues for a modern healthcare workforce. One issue is patient-targeted Googling, which involves a healthcare professional using a social networking site or publicly available search engine to find patient information online. The study’s aim was to address a deficit in data and knowledge regarding PTG, and to investigate medical student use of SNSs due to a close association with PTG. Method The authors surveyed final year medical students at the (...) Otago Medical School, University of Otago in January 2016. A subset completed focus groups that were analysed using thematic analysis to identify key themes relating to students’ attitudes towards PTG, and reasons why they might engage in PTG. Results Fifty-four students completed the survey, which showed that PTG was uncommon. Attitudes were varied and context dependent. Most participants saw problems with PTG and favoured more explicit guidance on the issue. SNS usage was high ; participants were concerned by the content of their SNS profiles and who they were connecting with online. Participants showing high SNS use were 1.83 times more likely to have conducted PTG than lower use groups. Conclusions The diverse attitudes uncovered in this study indicated that teaching or guidelines could be useful to healthcare professionals considering PTG. Though ethically problematic, PTG may be important to patient care and safety. The decision to conduct PTG should be made with consideration of ethical principles and the intended use of the information. (shrink)

The life perspectives of persons with disabilities have been neglected in many countries and particularly in lower- and middle-income countries that have fewer resources to adequately address the societal needs of these persons. Bioethics purports normative standards for the way in which we treat with others, and the virtue of care should be at the heart of everyday life. Human rights are norms that aspire to protect all persons everywhere. Within this milieu, persons with disabilities who make up a significant (...) portion of all societies worldwide meet many social barriers that inhibit their quality of life and leave them greatly disadvantaged in comparison to able-bodied persons. This article focuses on the notion of quality of life, the presumed perspectives of biomedicine and bioethics on disability, the neglect of the lived experience of persons with disabilities, and the discrimination underlying the struggle for equal rights and opportunities for persons with disability. It argues for equal access to social and beneficial medical interventions for persons with disabilities; that persons with disabilities should be seen as different but equal; that their contributions to societal deliberations would enhance the richness of thought, views, narratives and perspectives; and that society should stop using the term disability and use instead the less value-laden term anomaly. Finally, it recommends educational campaigns to change negative attitudes towards persons with predicaments or anomalies, the respecting of human diversity, collaboration between upper-income and lower- and middle-income countries to develop strategies that seek to change negative attitudes towards persons with anomalies, and the inclusion worldwide of all these matters as a part of a bioethics agenda that advocates for respecting the human rights of persons with anomalies. (shrink)

In the Caribbean as in many other areas costly biomedical resources and personnel are limited, and more and more people are turning to alternative medicine and folk practitioners for health care. To meet the goal of providing health care for all, research on nonbiomedical therapies is needed, along with legal recognition of folk practitioners to establish standards of practice.

Rare genetic diseases collectively impact millions of individuals in the United States. These patients and their families share many challenges including delayed diagnosis, lack of knowledgeable providers, and limited economic incentives to develop new therapies for small patient groups. As such, rare disease patients and families often must rely on advocacy, including both self-advocacy to access clinical care and public advocacy to advance research. However, these demands raise serious concerns for equity, as both care and research for a given disease (...) can depend on the education, financial resources, and social capital available to the patients in a given community. In this article, we utilize three case examples to illustrate ethical challenges at the intersection of rare diseases, advocacy and justice, including how reliance on advocacy in rare disease may drive unintended consequences for equity. We conclude with a discussion of opportunities for diverse stakeholders to begin to address these challenges. (shrink)

The aim of this paper is to bring recent work on metaphysical grounding to bear on the phenomenon of social construction. It is argued that grounding can be used to analyze social construction and that the grounding framework is helpful for articulating various claims and commitments of social constructionists, especially about social identities, e.g., gender and race. The paper also responds to a number of objections that have been leveled against the application of grounding to social construction from Elizabeth Barnes, (...) Mari Mikkola, and Jessica Wilson. (shrink)

Emotions involve complex processes produced by interactions between motives, beliefs, percepts, etc. E.g. real or imagined fulfilment or violation of a motive, or triggering of a 'motive-generator', can disturb processes produced by other motives. To understand emotions, therefore, we need to understand motives and the types of processes they can produce. This leads to a study of the global architecture of a mind. Some constraints on the evolution of minds are disussed. Types of motives and the processes they generate are (...) sketched. (shrink)

Timothy Williamson has argued that a person S ’s total evidence is constituted solely by propositions that S knows. This theory of evidence entails that a false belief can not be a part of S ’s evidence base for a conclusion. I argue by counterexample that this thesis (E = K for now) forces an implausible separation between what it means for a belief to be justified and rational from one’s perspective and what it means to base one’s beliefs on (...) the evidence. Furthermore, I argue that E = K entails the implausible result that there are cases in which a well-evidenced belief necessarily can not serve as evidence for a further proposition. (shrink)

In their target article, McKay & Dennett (M&D) conclude that only “positive illusions” are adaptive misbeliefs. Relying on overly strict conceptual schisms (deficit vs. motivational, functional vs. organic, perception vs. belief), they prematurely discount delusions asbiologicallyadaptive. In contrast to their view that “motivation” plays a psychological but not a biological function in a two-factor model of the forming and maintenance of delusions, we propose asingleimpairment in prediction-error–driven (i.e., motivational) learning in three stages in which delusions play a biologically adaptive role.

This paper introduces a new approach to the theory of truthmaking. According to this approach, there are multiple forms of truthmaking. Here, I characterize and motivate a specific version of this approach, which I call a ‘Pluralist Theory of Truthmaking.’ It is suggested that truthmaking is a plural, variegated phenomenon wherein different kinds of truths, e.g., positive truths, negative truths, counterfactual truths, etc., are made true in different ways. While the paper only aims to lay the groundwork for a Pluralist (...) Theory of Truthmaking, I show how the theory can be applied to positive and negative truths. The upshot of this application is that truthmaking pluralism allows us to provide negative truths with ‘non-suspicious’ truthmakers. Finally, it is argued that Truthmaker Maximalists would do well to endorse truthmaking pluralism, as it offers a new strategy for upholding Maximalism while diminishing controversial ontological commitments. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hume Studies Volume XXVI, Number 1, April 2000, pp. 171-177 Hume's Revised Racism Revisited AARON GARRETT John Immerwahr's brief note "Hume's Revised Racism" is doubtless one of the most intriguing recent discussions of Hume and racism.1 Immerwahr presents a thesis as to why Hume revised a footnote originally added to his essay "Of National Characters" (hereafter "ONC") in 1753. In this note I will examine and dispute Immerwahr's (...) thesis, which I believe can be shown to be seriously flawed. It is important to do so, as Immerwahr's note has been quoted a number of times in books and articles on Hume, and his thesis has been taken as gospel without sufficient examination of the grounds for his claims.2 As a consequence, Immerwahr's thesis is in danger of becoming a stubborn belief, even if not properly supportable. The controversy about Hume's racism centers on one infamous footnote added to the essay "Of National Characters" in the 1753-1754 edition of Essays and Treatises on Several Subjects. Why should we care about one footnote? We should care because the footnote seems to go against the image of a philosopher we thought we knew, and whom we likely esteem. In addition, it is shockingly bigoted. It reads in its entirety: I am apt to suspect the negroes, and in general all the other species of men (for there are four or five different kinds) to be naturally inferior to the whites. There never was a civilized nation of any other complexion than white, nor even any individual eminent either in action or speculation. No ingenious manufactures amongst them, no arts, no Aaron Garrett is at the Department of Philosophy, Boston University, 745 Commonwealth Avenue, Boston, MA 02215, USA. e-mail: [email protected] 172 Aaron Ganett sciences. On the other hand, the most rude and barbarous of the whites, such as the ancient Germans, the present Tartars, have still something eminent about them, in their valour, form of government, or some other particular. Such a uniform and constant difference could not happen, in so many countries and ages, if nature had not made an original distinction betwixt these breeds of men. Not to mention our colonies, there are Negroe slaves dispersed all over Europe, of which none ever discovered any symptom of ingenuity; tho' low people, without education, will start up amongst us, and distinguish themselves in every profession. In Jamaica, indeed, they talk of one negroe as a man of parts and learning; but 'tis likely he is admired for very slender accomplishments, like a parrot, who speaks a few words plainly.3 The footnote was not present in the 1748 edition of the Essays, Moral and Political, or Three Essays, Moral and Political, where ONC first saw light. In the 1768 edition there is one very minor alteration (from "tho' low people" to "though low people"). In the 1770 edition the footnote becomes an endnote, M,4 and there are again a few minor changes (from "betwixt these breeds of men" to "between these breeds of men"; from "of which never discovered" to "of whom never discovered"; for "'tis likely he is admired," read "it is likely he is admired") and one interesting substantive change (for "admired for very slender accomplishments," read "admired for slender accomplishments"). The most important change from the 1753 version of the note is in the 1777 posthumous edition, which Hume had corrected before he died. Hume rewrote the first two lines of 177OM, to read in 1777M: I am apt to suspect the negroes to be naturally inferior to the whites. There scarcely ever was a civilized nation of that complexion, nor even any individual eminent either in action or speculation.5 In "Hume's Revised Racism," Immerwahr argues that it is likely that Hume, after reading James Beattie's "Essay On Truth" and in light of his criticisms, revised the footnote in the 1777 edition of ONC. Immerwahr cites two pieces of evidence, a letter from Hume to Strahan to which he refers but does not quote, and Beattie's criticisms of Hume, which Hume may have read (although how much of it he read... (shrink)

I criticize the idea that theories of ‘fragmented’ or ‘compartmentalized’ belief (as found in, e.g., Lewis 1982, Egan 2008) can help to account for the puzzling phenomena they are often taken to account for. After introducing fragmentationalism and a paradigm case that purportedly motivates it, I criticize the view primarily on the grounds that the models and explanations it offers are at best trivial—as witnessed by examples of over-generation—and should be seen as merely re-describing in figurative terms the phenomena it (...) is designed to account for. I also point out that fragments, as used in these theories, are not likely to be psychologically real in any robust sense and so cannot be appealed to on such grounds. (shrink)

Aarons recognizes the usefulnes of markets, but argues that without some conscious human control they are unsustainable and would ultimately destroy the conditions for human life on the planet.

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 8.4 (2001) 317-322 [Access article in PDF] On Wolfgang Blankenburg, Common Sense, and Schizophrenia Aaron L. Mishara Introduction In its increasing openness to neuroscience (Cowan, Harter, and Kandel 2000) and other of its neighboring disciplines, mainstream biological psychiatry has allowed psychopathology, philosophy, and philosophical approaches to psychopathology to play an increased role in current research interests. Given this new openness, and the acknowledgment of (...) the severity of one of psychiatry's most debilitating, costly, and intractable disorders, 1 the translation of W. Blankenburg's 1969 article concerning the psychopathology of common sense does not merely serve historical interest. It is an exceptional example of a not well-known trend in German- and French-speaking psychiatry to apply philosophical phenomenology and existentialism to psychopathological research. This trend, which reached a peak in the late 1950s and was strong well into the 1970s, has dwindling, but nevertheless, current representatives in Heidelberg and Zurich and is scattered in a few other places in Europe, Japan, the United States, and South America. The view of the Zeitgeist—which may sound astonishing, even antiquated to contemporary readers—was highly ambitious: Conceptual approaches, such as philosophical ("transcendental") phenomenology, were expected to supply knowledge about the structure of consciousness and its disturbance in various mental disorders.Following the lead of Binswanger and Szilasi, who viewed schizophrenia as an "experiment of nature" that enables us to view underlying processes otherwise hidden to "natural, everyday consciousness," Blankenburg believed that it may be possible to map the formal properties of the psychopathology of schizophrenia—precisely in the loss of common sense—as a disturbance to the basic organization of conscious experience. Any attempt to summarize this rather abstract and complex approach in a brief commentary would be ill advised. In passing, rather, I will remark that such efforts could have profound relevance to the current research of schizophrenia and its underlying neurobiology. This research has gradually acknowledged the importance of taking the patient's subjective experience of the disorder into account (Mishara, Parnas, and Naudin 1998). In this commentary, I will first give an account of the biographical and clinical reasons that led Blankenburg to turn to the problem of common sense and its relevance for schizophrenia. I will then explore what implications [End Page 317] his work may have for more recent findings concerning schizophrenia. Blankenburg's Intellectual Development Born in 1928, W. Blankenburg, the son of a Lufthansa pilot who pioneered transatlantic commercial flights, began his studies in Freiburg im Breisgau in 1947. While at Freiburg, Blankenburg heard lectures in philosophy given by E. Fink (the former assistant to Husserl) and Max Mueller, and in psychology, by R. Heiss and others. After three years, Blankenburg turned to the study of medicine, producing a dissertation in 1956 on an application of Daseinsanalysis (Heidegger and Binswanger) to a case of paranoid schizophrenia. Binswanger wrote the forward to the publication. Between 1956 and 1958, Blankenburg studied internal medicine in Heidelberg with the accomplished phenomenologist of bodily experience (Leibphaenomenologer) and student of V. von Weizsaecker Herbert Pluegge. He spent one semester in Goettingen where he attended lectures by the ontological philosopher Nicolai Hartmann, who provided for Blankenburg a more useful approach to the problem of nature and natural science than Heidegger's primary emphasis on the question of Being. During his Freiburg years, Blankenburg attended small seminars led by Heidegger in the Schwarzwald forest. (Heidegger had been forbidden to teach after the end of World War II.) Blankenburg recalls that the participants would sit on logs in an open field as if to invoke Heidegger's concept of the clearing (Lichtung) of Being. While not entirely sympathetic with Heidegger's philosophy, Blankenburg learned to carefully "listen"—as Heidegger would repeatedly emphasize—to language, not merely poetic or philosophical language, but the language of the patients he would meet in clinical practice.During this time, Blankenburg heard lectures by W. Szilasi, the philosopher-scientist who held Husserl's and Heidegger's chair in the department of philosophy. Szilasi collaborated with the phenomenological psychiatrist, L. Binswanger. Their effort to apply concepts from Husserl's... (shrink)

Epistemic justifications for democracy have been offered in terms of two different aspects of decision-making: voting and deliberation, or ‘votes’ and ‘talk.’ The Condorcet Jury Theorem is appealed to as a justification in terms votes, and the Hong-Page “Diversity Trumps Ability” result is appealed to as a justification in terms of deliberation. Both of these, however, are most plausibly construed as models of direct democracy, with full and direct participation across the population. In this paper, we explore how these results (...) hold up if we vary the model so as to reflect the more familiar democratic structure of a representative hierarchy. We first recount extant analytic work that shows that representation inevitably weakens the voting results of the Condorcet Jury Theorem, but we question the ability of that result to shine light on real representative systems. We then show that, when we move from votes to talk, as modeled in Hong-Page, representation holds its own and even has a slight edge. (shrink)

Religious healing specialists such as shamans often use magic. Evolutionary theories that seek to explain why laypersons find these specialists convincing focus on the origins of magical cognition and belief in the supernatural. In two studies, we reframe the problem by investigating relationships among ethnomedical specialists, who possess extensive theories of disease that can often appear “supernatural,” and religious healing specialists. In study 1, we coded and analyzed cross-cultural descriptions of ethnomedical specialists in 47 cultures, finding 24% were also religious (...) leaders and 74% used supernatural theories of disease. We identified correlates of the use of supernatural concepts among ethnomedical specialists; incentives and disincentives to patronize ethnomedical specialists; and distinct clusters of ethnomedical specialists that we label prestigious teachers, feared diviners, and efficacious healers. In study 2, we interviewed 84 Maasai pastoralists and their traditional religious and non-religious healing specialists. We found that laypersons relied on medicinal services based on combinations of efficacy, religious identity, and interpersonal trust. Further, laypersons and specialists largely used abstract concepts that were not conspicuously supernatural to describe how local medicines work. We conclude that religious healers in traditional societies often fulfill a practical and specialized service to local clients, and argue that supernatural theories of disease often reflect abstract cognition about rare phenomena whose causes are unobservable (e.g., infection, mental illness) instead of a separate “religious” style of thinking. (shrink)

Counter storytelling, used in critical race theory and narrative ethics, is a tool used to contradict and expose the oppression in a dominant narrative, by focusing attention on the stories of the...

Launched in 1971, _Adolescent Psychiatry,_ in the words of founding coeditors Sherman C. Feinstein, Peter L. Giovacchinni, and Arthur A. Miller, promised "to explore adolescence as a process... to enter challenging and exciting areas that may have profound effects on our basic concepts." Further, they promised "a series that will provide a forum for the expression of ideas and problems that plague and excite so many of us working in this enigmatic but fascinating field." For over two decades, Adolescent Psychiatry (...) has fulfilled this promise. The repository of a wealth of original studies by preeminent clinicians, developmental researchers, and social scientists specializing in this stage of life, the series has become an essential resource for all mental health practitioners working with youth. With volume 22, the editorship of _Adolescent Psychiatry_ passes to Aaron E. Esman, a distinguished clinician and educator whose wide-ranging sensibilities gain expression in a collection rich in clinical, developmental, and scholarly insight. Encompassing developmental topics timely clinical issues, historical commentaries, and a special section on "ambient genocide and adolescence," volume 22 ably meets the needs of professional and scholarly readers interested in this vitally important stage of life. (shrink)

Recent advances in the field of statistical learning have established that learners are able to track regularities of multimodal stimuli, yet it is unknown whether the statistical computations are performed on integrated representations or on separate, unimodal representations. In the present study, we investigated the ability of adults to integrate audio and visual input during statistical learning. We presented learners with a speech stream synchronized with a video of a speaker’s face. In the critical condition, the visual (e.g. /gi/) and (...) auditory (e.g. /mi/) signals were occasionally incongruent, which we predicted would produce the McGurk illusion, resulting in the perception of an audiovisual syllable (e.g. /ni/). In this way, we used the McGurk illusion to manipulate the underlying statistical structure of the speech streams, such that perception of these illusory syllables facilitated participants’ ability to segment the speech stream. Our results therefore demonstrate that participants can integrate audio and visual input to perceive the McGurk illusion during statistical learning. We interpret our findings as support for modality-interactive accounts of statistical learning. (shrink)

This paper extends three decades of work arguing that researchers who discuss consciousness should not restrict themselves only to (adult) human minds, but should study (and attempt to model) many kinds of minds, natural and artificial, thereby contributing to our understanding of the space containing all of them. We need to study what they do or can do, how they can do it, and how the natural ones can be emulated in synthetic minds. That requires: (a) understanding sets of requirements (...) that are met by different sorts of minds, i.e. the niches that they occupy, (b) understanding the space of possible designs, and (c) understanding complex and varied relationships between requirements and designs. Attempts to model or explain any particular phenomenon, such as vision, emotion, learning, language use, or consciousness lead to muddle and confusion unless they are placed in that broader context. A methodology for making progress is summarised and a novel requirement proposed for a theory of how human minds work: the theory should support a single generic design for a learning, developing system that, in addition to meeting familiar requirements, should be capable of developing different and opposed philosophical viewpoints about consciousness, and the so-called hard problem. In other words, we need a common explanation for the mental machinations of mysterians, materialists, functionalists, identity theorists, and those who regard all such theories as attempting to answer incoherent questions. No designs proposed so far come close. (shrink)

When performing a skilled action—whether something impressive like a double somersault or something mundane like reaching for a glass of water—you exercise control over your bodily movements. Specifically, you guide their course. In what does that control consist? In this dissertation, I argue that it consists in attending to what you are doing. More specifically, in attending, agents harness their perceptual and perceptuomotor states directly and practically in service of their goals and, in doing so, settle the fine-grained manner in (...) which their bodies will move—details an intention alone leaves unsettled. This requires, among other things, that we reject views on which agents’ control is identical with their practical rationality. When all goes well, agents attentionally prioritize what is motivationally relevant to them to the exclusion of what would otherwise distract them from achieving their goals. However, sometimes agents attend distractedly—i.e., without prioritizing. As the aim of attention is to avoid distraction, this entails the possibility of defective attention. Defective attention, in turn, casts light on scenarios in which agents lose control over what they are doing, as when a skilled practitioner ‘chokes under pressure’. A complaint sometimes levelled against accounts, like mine, that claim to reduce agents’ control of their behaviour to that of causally efficacious mental states or events is that these accounts invariably deprive agents themselves of their rightful role in the generation of behaviour. This is the “Disappearing Agent Problem” for “reductive” or “event-causal” theories of action. I argue that, correctly understood, extant reductive theories do face a genuine Disappearing Agent Problem. However, it is a problem we solve by recognizing the role that conscious attention plays in making an action the agent’s own. Accordingly, I develop and defend an attentional account of action ownership. On this view, allocating conscious attention in service of your goals is sufficient for a kind of conscious perspective (“motivational perspective”), which, when active in controlling your behaviour, constitutes the behaviour as your own doing. As I explain, such perspective also contributes to explaining the subjective structure of your perceptual awareness of the world around you. (shrink)

Fighting ability, although recognized as fundamental to intrasexual competition in many nonhuman species, has received little attention as an explanatory variable in the social sciences. Multiple lines of evidence from archaeology, criminology, anthropology, physiology, and psychology suggest that fighting ability was a crucial aspect of intrasexual competition for ancestral human males, and this has contributed to the evolution of numerous physical and psychological sex differences. Because fighting ability was relevant to many domains of interaction, male psychology should have evolved such (...) that a man’s attitudes and behavioral responses are calibrated according to his formidability. Data are reviewed showing that better fighters feel entitled to better outcomes, set lower thresholds for anger/aggression, have self-favoring political attitudes, and believe more in the utility of warfare. New data are presented showing that among Hollywood actors, those selected for their physical strength (i.e., action stars) are more likely to believe in the utility of warfare. (shrink)

Draft for presentation at the 14th International Kant-Congress, September 2024. -/- Abstract: Kant claims we intuit infinite space. There’s a problem: Kant thinks full awareness of infinite space requires synthesis—the act of putting representations together and comprehending them as one. But our ability to synthesize is finite. Tobias Rosefeldt has argued in a recent paper that Kant’s notion of decomposing synthesis offers a solution. This talk criticizes Rosefeldt’s approach. First, Rosefeldt is committed to nonconceptual yet determinate awareness of (potentially) infinite (...) space, but I argue that such awareness is (1) prima facie implausible, as well as contravened by textual evidence from Kant’s (2a) definitions of ‘infinity’ and (2b) account of geometrical construction. Second, scrutiny of how Kant thinks awareness of potential infinity is afforded by geometrical construction (e.g., extending a line segment ad indefinitum) indicates no essential role for decomposing synthesis. Familiar synthesis from parts to wholes is sufficient. (shrink)

The authors present a materialist analysis of the effects of neoliberalism in education. Specifically, they contend that neoliberalism is a form of cultural invasion that begets necrophilia. Neoliberalism is necrophilous in promoting a cultural desire to fix fluid systems and processes. Such desire manufactures both individuals known and culturally felt experiences of alienation which are, it is argued, symptomatic of an imperialist nostalgia that permeates educational policy and practice. The authors point to ‘unschooling in schools’ as a mechanism for resisting (...) the necrophilous tendencies of contemporary formations of education. (shrink)

From the earliest application of modern randomized controlled trials in medical research, scientists and observers have deliberated the ethics of randomly allocating study participants to trial control arms. Adaptive RCT designs have been promoted as ethically advantageous over conventional RCTs because they reduce the allocation of subjects to what appear to be inferior treatments. Critical assessment of this claim is important, as adaptive designs are changing medical research, with the potential to significantly shift how clinical trials are conducted. Policy-makers are (...) swiftly moving to encourage greater use of adaptive designs. In 2016, the newly enacted 21st Century Cures Act instructed the Food and Drug Administration to help product sponsors incorporate adaptive methods into proposed clinical trial protocols and applications for investigational drugs and also biological products. In this article, we review the ethical justifications commonly offered for adaptive designs, explore these arguments in the context of actual trials, and contend that clinical equipoise is a useful standard for adaptive-trial ethics. We distinguish between theoretical and clinical equipoise and explain why ethical arguments related to adaptive trials tend to focus on the former. Yet we contend that theoretical equipoise can be an unreliable standard for adaptive ethics. While we contend that clinical equipoise is the most critical principle for the primary ethical concerns posed by adaptive trials, we suggest ethical approaches to deal with some additional concerns unique to adaptive designs. (shrink)

It is not uncommon to hear that poor school performance, welfare dependancy, youth unemployment, and criminal activity result more from shortcomings in the personal makeup of individuals than from societal forces beyond their control. Are American values declining as so many suggest? And are those values at the root of many social problems today?Shaped by experience and public policies, people's values and social norms do change. What role can or should a democratic government play in shaping values? And how do (...) these values conditon the efficacy of public policy?In this book, six distinguished social scientists identify trends in America's values and their consequences, and consider public policy tools with which some of those values might be changed.Daniel Yankelovich begins with a discussion of how American values have shifted in the last half-century, and argues that affluence is the driving force behind these changes in values. James Q. Wilson argues that destructive habits which can lead to social pathologies, like crime and drug use, are set early in life; he examines how public policy might intervene when children are young to promote better values. David Popenoe maintains that America has veered too far towards industrialist values, and explores the resulting decline of families and many attendant social ills. Nathan Glazer describes the history and present status of the dispute over multicultural education. Jane Mansbridge examines the process of building cooperation, consensus, and public spirit. And George Akerlof and Janet L. Yellen discuss the problem of gang criminality.Inthe past, social scientists have often sidestepped questions about values as undefinable, unquantifiable, and somehow unscientific. The essays in this volume address these questions at last.Henry J. Aaron, director of the Economic Studies program at Brookings, is the authorof numerous books, including most recently Serious and Unstable Condition: Financing America's Health Care (1991), and coeditor of Setting Domestic Priorities (1992). Thomas E. Mann is director of the Brookings Governmental Studies program, coeditor of Media Polls in American Politics (1992), and coauthor of the Renewing Congress series (1993). Timothy Taylor is managing editor of the Journal of Economic Perspectives at Stanford University. (shrink)

On Peirce’ view, we can perceive many things commonly thought not to be perceptible—or thought to be ‘abstract’—including but not necessarily limited to (some) generals or universals, habits or law-like properties, modal properties, and semeiotic properties (sign relations). My contention turns on his arguments in ‘Some Consequences’ that ‘no cognition of ours is absolutely determinate’, his mature account of perception, particularly his criteria for what counts as perception and what does not, his analysis of the predication of concepts (i.e. his (...) pragmaticism), his claims in the 1903 Harvard lectures that we directly perceive Thirdness, and his realism about generals, habits, modalities, and sign relations. (shrink)