Health care institutions must decide whether to inform the patient of a medical error. The barriers to disclosure are an aversion to admitting errors, a concern about implicating other practitioners, and a fear of lawsuits and liability. However, admission of medical errors is the ethical thing to do and may be required by law. When examined, the barriers to such disclosures have little merit, and, in fact, lawsuits and liability may actually be reduced by informing the patient of medical errors. (...) Therefore, a health care institution should implement a written policy providing for disclosure of medical errors, using a process such as that outlined in the article. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 11.2 (2001) 115-116 [Access article in PDF] The Ethics of Medical Mistakes: Historical, Legal, and Institutional Perspectives Introduction In late 1999, the Institute of Medicine (IOM) released its report on medical errors, To Err is Human: Building a Safer Health System. The report estimated almost 50,000 deaths per year nationally due to medical mistakes, making it a leading cause of death. IOM speculated that (...) more than half of the deaths related to medical error are preventable. The IOM report shocked the public and medical professionals alike, sparking a national discussion of how to make the health care system safer. This multifaceted issue has profound implications for all aspects of health care, from the very personal--e.g., the relationship of caregiver and patient--to the societal--e.g., a nation's responsibility to its citizens.On 15 May 2000, the University of Pittsburgh Medical Center hosted an ethics conference devoted to the topic of medical mistakes. The goal was to bring together experts from various disciplines, before an audience of both providers and patients, to discuss medical mistakes and their implications. In this issue of the Kennedy Institute of Ethics Journal, we present selected papers resulting from that conference. These papers reflect not only the original oral presentations, but also much of the discussion those presentations generated. Three key perspectives on the ethics of medical mistakes are offered: historical, legal, and institutional.Rosa Lynn Pinkus offers a revealing historical perspective on the ethics of medical mistakes. In analyzing the history of mistake reporting in neurosurgery, she shows how the notion of a mistake developed only as the notion of a standard of practice emerged. Although much of managed care is directed toward systematically fostering a standard of care, this pursuit is relatively new in health care. One might speculate that as more standards are created, mistakes--defined as deviations from standard practice--must increase. If deviation from standard practice is overly castigated, however, then needed innovation in practice may be stifled. Interestingly, as Pinkus discusses, medical malpractice suits quickly followed the emergence of practice standards, driving the initial open reporting of mistakes underground. [End Page 115]Taking up the issue of medical malpractice, Thomas May and Mark Aulisio consider the ramifications of the current malpractice system for mistake prevention. The current system, they argue, while failing to adequately achieve its purported goals of deterring medical mistakes and compensating victims, itself creates a climate that deters the open reporting of mistakes by engendering fear and shame in clinicians. According to May and Aulisio, this failure to report medical mistakes openly has serious ramifications. Chief among these is the inability to do root cause analysis of mistakes, and then, where possible, to implement safeguards to minimize the occurrence of future mistakes. Ultimately, both the prevention of medical mistakes and the goals of malpractice litigation itself will be better served if substantial malpractice reform is undertaken.Andy Thurman argues that even in the current climate institutions ought to have a policy (and practice) of admitting to and openly reporting medical mistakes. Thurman argues that doing so not only is the right thing to do, but is also in the interest of institutions. Interestingly, he contends that failing to admit and openly report mistakes is both at odds with the mission of health care institutions and puts them at higher risk of litigation, and liability. In light of this, Thurman then suggests an institutional process for handling medical mistakes.Michael DeVita concedes that disclosing mistakes is widely supported by the health professionals' principles of ethics, but argues that there are a number of factors that conspire to make doing so a very difficult task. In analyzing an index case, DeVita contends that platitudes about being honest are not nearly enough to foster honest behavior and that policies that offer specific guidance on handling unfavorable events are needed in health care institutions.Finally, we conclude with the policy on disclosure of unfavorable events (this terminology is chosen because it includes both iatrogenic and natural diseases and conditions) that resulted from... (shrink)

In this book, Andy Mueller examines the ways in which epistemic and practical rationality are intertwined. In the first part, he presents an overview of the contemporary debates about epistemic norms for practical reasoning, and defends the thesis that epistemic rationality can make one practically irrational. Mueller proposes a contextualist account of epistemic norms for practical reasoning and introduces novel epistemic norms pertaining to ends and hope. In the second part Mueller considers current approaches to pragmatic encroachment in epistemology, (...) ultimately arguing in favor of a new principle-based argument for pragmatic encroachment. While the book defends tenets of the knowledge-first programme, one of its main conclusions is thoroughly pragmatist: in an important sense, the practical has primacy over the epistemic. (shrink)

Subjects with delusions profess to believe some extremely peculiar things. Patients with Capgras delusion sincerely assert that, for example, their spouses have been replaced by impostors. Patients with Cotard’s delusion sincerely assert that they are dead. Many philosophers and psychologists are hesitant to say that delusional subjects genuinely believe the contents of their delusions.2 One way to reinterpret delusional subjects is to say that we’ve misidentified the content of the problematic belief. So for example, rather than believing that his wife (...) is has been replaced by an impostor, we might say that the victim of Capgras delusion believes that it is, in some respects, as if his wife has been replaced by an impostor. Another is to say that we’ve misidentified the attitude that the delusional subject bears to the content of their delusion. So for example, Gregory Currie and co-authors have suggested that rather than believing that his wife has been replaced by an impostor, we should say that the victim of Capgras delusion merely imagines that his wife has been replaced by an impostor.3. (shrink)

This book presents the major teachings of Mahāyāna Buddhism in a precise, dramatic, and even humorous form. For two millennia this Sūtra, called the “jewel of the _Mahāyāna Sūtras_,” has enjoyed immense popularity among Mahāyāna Buddhists in India, central and southeast Asia, Japan, and especially China, where its incidents were the basis for a style in art and literature prevalent during several centuries. Robert Thurman’s translation makes available in relatively nontechnical English the Tibetan version of this key Buddhist scripture, (...) previously known to the English-speaking world only through translations from Chinese texts. The _Tibetan_ version is generally conceded to be more faithful to the original Sanskrit than are the Chinese texts. The Tibetan version also is clearer, richer, and more precise in its philosophical and psychological expression. The twelve books of the Sūtra are accompanied by an introduction and an epilogue by Dr. Thurman and by three glossaries: Sanskrit terms, numerical categories, and technical terms. (shrink)

“There’s no disputing about taste.” That’s got a nice ring to it, but it’s not quite the ring of truth. While there’s definitely something right about the aphorism – there’s a reason why it is, after all, an aphorism, and why its utterance tends to produce so much nodding of heads and muttering of “just so” and “yes, quite” – it’s surprisingly difficult to put one’s finger on just what the truth in the neighborhood is, exactly. One thing that’s pretty (...) clear is that what’s right about the aphorism, that there’s no disputing about taste, isn’t that there’s no disputing about taste. There’s heaps of disputing about taste. People engage in disputes about which movies, music, paintings, literature, meals, furniture, architectural styles, etc. are good, beautiful, tasty, fun, elegant, ugly, disgusting, etc. all the time. This is obvious to anyone who has watched dueling-movie-critics shows, read theater reviews, or negotiated with a group or partner about which movie or restaurant to go to, or which sofa or painting to put in the living room. It takes great care and good aim to fling a brick without hitting somebody who’s engaged in a dispute about taste. (shrink)

We show that a popular class of connectionist models (which we label 'first order connectionism') looks unlikely to provide the kind of resources required by the hypothesis. We examine some alternative hybrid models that seem more promising. Finally, we raise a more purely philosophical issue concerning the conditions under which a being can count as a genuine believer or cognizer.".

Aesthetics and Music is a rich and interesting study. Hamilton's approach is innovative. He interleaves chapters on the history of philosophical thought about music with more theoretical discussions of music, sound, rhythm and improvisation, but does not cover the work–performance relation, depiction or expression. He draws on an atypically broad range of examples, including avant-garde, medieval, non-Western and jazz. The assumptions are humanist: ‘I wish to argue for an aesthetic conception of music as an art … according to which music (...) is a human activity grounded in the body and bodily movement and interfused with human life’.The historical chapters are valuable and not without analysis and criticism. Hamilton shows how the ancient Greek theorists were more interested in music's mathematical properties as reflecting the underlying harmony of relations between cosmic bodies than in the practice of musicians. While they equated the value of art with its contribution to an education for citizenship and while their concept of the arts differed …. (shrink)

In this case, when the ethics committee is asked the questions that should be addressed are.

There is a lot that we don't know. That means that there are a lot of possibilities that are, epistemically speaking, open. For instance, we don't know whether it rained in Seattle yesterday. So, for us at least, there is an epistemic possibility where it rained in Seattle yesterday, and one where it did not. What are these epistemic possibilities? They do not match up with metaphysical possibilities - there are various cases where something is epistemically possible but not metaphysically (...) possible, and vice versa. How do we understand the semantics of statements of epistemic modality? The ten new essays in this volume explore various answers to these questions, including those offered by contextualism, relativism, and expressivism. (shrink)

My understanding is that proximate explanations concern adaptive mechanism and that ultimate explanations concern adaptive rationale. Viewed in this light, the two kinds of explanation are quite distinct, but they interact in a complementary way to give a full understanding of biological adaptations. In contrast, Laland et al. (2013)—following a literal reading of Mayr (Science 134:1501–1506, 1961)—have characterized ultimate explanations as concerning any and all mechanisms that have operated over the course of an organism’s evolutionary history. This has unfortunate consequences, (...) such as allowing random drift to form the basis for ultimate explanations, and allowing proximate and ultimate explanations to bleed into each other until their distinction is meaningless. Here, I suggest Laland et al’s explanatory framework of “reciprocal causation” is not conducive to successful biological science, and that they have misunderstood key elements of the theory of Darwinian adaptation. (shrink)

The use of forward models is well established in cognitive and computational neuroscience. We compare and contrast two recent, but interestingly divergent, accounts of the place of forward models in the human cognitive architecture. On the Auxiliary Forward Model account, forward models are special-purpose prediction mechanisms implemented by additional circuitry distinct from core mechanisms of perception and action. On the Integral Forward Model account, forward models lie at the heart of all forms of perception and action. We compare these neighbouring (...) but importantly different visions and consider their implications for the cognitive sciences. We end by asking what kinds of empirical research might offer evidence favouring one or the other of these approaches. (shrink)

Problems about the accidental properties of properties motivate us--force us, I think--not to identify properties with the sets of their instances. If we identify them instead with functions from worlds to extensions, we get a theory of properties that is neutral with respect to disputes over counterpart theory, and we avoid a problem for Lewis's theory of events. Similar problems about the temporary properties of properties motivate us--though this time they probably don't force us--to give up this theory as well, (...) and to identify properties with functions from world, time pairs to extensions. Again, the replacement theory is neutral with respect to a metaphysical dispute that the old theory (arguably) forces us to take a stand on--the dispute over whether objects have temporal parts. It also allows us to give a smoother semantics for predication, to better accommodate our intuitions about which objects temporary properties are properties of, and to make temporally self-locating beliefs genuinely self -locating. (shrink)

Philosophical Explorations, Volume 15, Issue 2, Page 87-90, June 2012.

I will argue for a novel variant of the knowledge norm for practical reasoning. In Sect. 2, I will look at current variations of a knowledge norm for practical reasoning and I will provide reasons to doubt these proposals. In Sects. 3 and 4, I develop my own proposal according to which knowledge is the norm of apt practical reasoning. Section 5 considers objections. Finally, Sect. 6 concerns the normativity of my proposed knowledge norm and its significance.

Ferrari's book takes on the commendable project of developing a systematic account of truth, normativity, and disagreement, according to which truth plays a var.

Idioms – expressions like kick the bucket and let the cat out of the bag – are strange. They behave in ways that ordinary multi-word expressions do not. One distinctive and troublesome feature of idioms is their unpredictability: The meanings of sentences in which idiomatic phrases occur are not the ones that we would get by applying the usual compositional rules to the usual meanings of their (apparent) constituents. This sort of behavior requires an explanation. I will argue that the (...) right explanation is that the sentences are being interpreted through a pretense. (What this means, exactly, will be explained in what follows.) This is a surprising claim, for two reasons. On the one hand, it seems that adopting a pretense account is overkill—it’s a far more radical move than is required to account for the phenomena. On the other hand, it seems that a pretense account is hopeless—that there is a fatal overgeneration problem for pretense accounts of idiom that causes them to fail, as Jason Stanley charges, “as badly as it is possible for an account of idiom to fail.” So I will have some work to do. (shrink)

In Supersizing the Mind, Andy Clark argues that the human mind is not bound inside the head but extends into body and environment.

I argue against Schroeder's explanation of pragmatic encroachment on knowledge. In section 1, I introduce pragmatic encroachment and point out that an explanation of it should avoid Pascalian considerations. In section 2, summarize the key aspects of Schroeder's explanation of pragmatic encroachment. In section 3, I argue that Schroeder's explanation faces a dilemma: it either allows for an objectionable form of Pascalian encroachment or it fails to be a fully general explanation of pragmatic encroachment.

Mind, it has recently been argued1, is a thoroughly temporal phenomenon: so temporal, indeed, as to defy description and analysis using the traditional computational tools of cognitive scientific understanding. The proper explanatory tools, so the suggestion goes, are instead the geometric constructs and differential equations of Dynamical Systems Theory. I consider various aspects of the putative temporal challenge to computational understanding, and show that the root problem turns on the presence of a certain kind of causal web: a web that (...) involves multiple components (both inner and outer) linked by chains of continuous and reciprocal causal influence. There is, however, no compelling route from such facts about causal and temporal complexity to the radical anti- computationalist conclusion. This is because, interactive complexities notwithstanding, the computational approach provides a kind of explanatory understanding that cannot (I suggest) be recreated using the alternative resources of pure Dynamical Systems Theory. In particular, it provides a means of mapping information flow onto causal structure -- a mapping that is crucial to understanding the distinctive kinds of flexibility and control characteristic of truly mindful engagements with the world. Where we confront especially complex interactive causal webs, however, it does indeed become harder to isolate the syntactic vehicles required by the computational approach. Dynamical Systems Theory, I conclude, may play a vital role in recovering such vehicles from the burgeoning mass of real-time interactive complexity. (shrink)

This article discusses how research on the image-based analysis of facial images has informed this debate by demonstrating that a single representational system for facial identity and facial expression is not only computationally viable, but can simulate existing cognitive data demonstrating apparent dissociable processing of these two facial properties. It discusses the increasing number of cognitive studies that provide support for this view. Neuropsychological case studies of brain-injured patients and provide limited evidence for separate visual routes processing facial identity and (...) facial expression. It deals with neuroimaging studies addressing both facial identity and facial expression processing which shows that the fusiform gyrus contributes to the recognition of both facial properties. Research continues to reinforce the proposal that a common visual framework supports the representation of at least some aspects of facial identity and facial expression. (shrink)

There have been few attempts to answer the challenges for alethic pluralists to maintain standard accounts of the logical operators and of logical consequence in a sufficiently systematic and precise way. This chapter presents a pluralist account of logic and semantics that answers these challenges. The chapter also shows how to accommodate logical pluralism and ontological pluralism within an extension of the framework.

Within the past few years, the topic of human dignity has demonstrated distinct signs of a revitalization of interest both within and beyond academic discourse. Outside the academy, news headlines and Twitter feeds continue to generate discussions about whose lives matter, both in the United States and abroad. This has served to renject into civil discourse, with a renewed sense of urgency, the question: what does it mean for a human life to matter? What does it mean for a human (...) life to have dignity? Within the academy,1 scholars have recently approached this question by focusing on how to renegotiate and... (shrink)

Where does the mind stop and the rest of the world begin? The question invites two standard replies. Some accept the demarcations of skin and skull, and say that what is outside the body is outside the mind. Others are impressed by arguments suggesting that the meaning of our words "just ain't in the head", and hold that this externalism about meaning carries over into an externalism about mind. We propose to pursue a third position. We advocate a very different (...) sort of externalism: an _active externalism_, based on the active role of the environment in driving cognitive processes. (shrink)

In this paper I examine the debate between ‘protectionists’ and ‘liberationists’ concerning the appropriate role of minors in decision-making about their health care, focusing particularly on disagreements between the two sides regarding adolescents. Protectionists advocate a more traditional, paternalistic approach in which minors have relatively little input into the healthcare decision-making process, and decisions are made for them by parents or other adults, guided by a commitment to the patient's best interests. Liberationists, on the other hand, argue in favour of (...) expanded participation by minors in treatment decisions, and decision-making authority for at least some adolescents. My examination of the debate includes discussion of liberationist shifts that have taken place in the medical community as well as in legal policy and practice, and consideration of recent research on adolescent development. In the final section of the paper, I propose a moderate position that addresses both liberationist and protectionist concerns. (shrink)

Parallel distributed processing is transforming the field of cognitive science. Microcognition provides a clear, readable guide to this emerging paradigm from a cognitive philosopher's point of view. It explains and explores the biological basis of PDP, its psychological importance, and its philosophical relevance.

In lieu of an abstract, here is a brief excerpt of the content:Buddhist-Christian Studies 21.1 (2001) 69-72 [Access article in PDF] Christian Experiences with Buddhist Spirituality: A Response Robert Thurman Columbia University Recently I read an account on the CNN website of a statement made at the Kumbh Mela at Allahabad in India, where about eighty million devotees of Hinduism were joined in their worship of the grace of the Goddess River Ganga by His Holiness the Dalai Lama, informal (...) head of Tibetan Buddhists and formal head of the Tibetan government in exile. His Holiness also joined the leaders of Hinduism, various Shankaracharyas and others, in a formal statement in which they requested with the followers of other world religions not to persist in the practice of aggressive conversion of the followers of other religions. The statement addressed a special plea to Christians and Muslims, who may currently be the most intense in their worldwide missionary activities.The writer of the CNN article was clearly cynical about this, mentioning, as if to undercut the force of their appeal to other religions, that the Hindu leaders themselves wanted to declare India a Hindu nation. He noted that the Dalai Lama "giggled" when he sprinkled himself with Ganga water out of respect for Hindu beliefs, but declined to immerse himself in the river, saying it was too cold.His Holiness has often challenged leaders of world religions, including Buddhists, Hindus, and secular humanists (which he considers a world religion/ideology, whether Marxist or liberal democratic), by saying that now is past the time when anyone should be attempting to convert others to a different belief system or institutional affiliation. If persisted in, it will lead to worse violence in the future than it already has in the past. His position seems eminently reasonable, looking realistically at the world situation, the powerful technologies of communication and possible scale of violence. Yet people filled with enthusiasm for their saving faith tend to feel deprived if they cannot have a mission to save others with it.I do not think His Holiness means that you cannot share your enthusiasm, or make the jewels of faith, wisdom, and compassion of your tradition accessible to others, or even dialogue with others comparing your tradition with theirs. He travels the world teaching Buddhism, mostly to Buddhists, but freely to anyone who is interested. But then he does tell those who are not Buddhists notto convert to Buddhism. Rather, he cautions, they should take whatever they learn and use anything that seems good to them to enhance their original tradition, thereby remaining integrated with [End Page 69] their families, communities, and local customs, perhaps even enriching their own traditions. Those who are Buddhists from birth he urges to study other traditions, learn from them, and critically extricate themselves from feelings of superiority or estrangement. And some who may already have chosen to become Buddhist he strongly cautions not to criticize their birth traditions or look down on their followers.What I love about the essays in this collection is that they all seem to be learning from Buddhism and appreciate its traditions, yet they interpret it in Christian terms, apply it to their own Christian understanding, and practice an enriched Christianity, perhaps what Bardwell Smith so aptly calls in his essay "becoming a Christian." I feel privileged to respond to the deep personal quest for truth I sense within each essay. I am not going to review each essay point by point, though I will touch on each of the five as I follow a kind of pilgrimage through them. Though all five essays are personal and confessional, those by Ingram and Muck are perhaps more theoretical in tone, Adeney and Frohlich more contemplative in focus, and Smith combines both in a special combination I will save for last.Paul Ingram writes as a man who floats contentedly in a sea of God's grace, the vision of which seems to have been opened for him by Martin Luther. While he floats, he reflects deeply and knowledgeably about both Pure Land and Zen Buddhisms, acknowledging how his appreciation of the Christian... (shrink)

Biological brains are increasingly cast as ‘prediction machines’: evolved organs whose core operating principle is to learn about the world by trying to predict their own patterns of sensory stimulation. This, some argue, should lead us to embrace a brain-bound ‘neurocentric’ vision of the mind. The mind, such views suggest, consists entirely in the skull-bound activity of the predictive brain. In this paper I reject the inference from predictive brains to skull-bound minds. Predictive brains, I hope to show, can be (...) apt participants in larger cognitive circuits. The path is thus cleared for a new synthesis in which predictive brains act as entry-points for ‘extended minds’, and embodiment and action contribute constitutively to knowing contact with the world. (shrink)

How is it that thoroughly physical material beings such as ourselves can think, dream, feel, create and understand ideas, theories and concepts? How does mere matter give rise to all these non-material mental states, including consciousness itself? An answer to this central question of our existence is emerging at the busy intersection of neuroscience, psychology, artificial intelligence, and robotics.In this groundbreaking work, philosopher and cognitive scientist Andy Clark explores exciting new theories from these fields that reveal minds like ours (...) to be prediction machines - devices that have evolved to anticipate the incoming streams of sensory stimulation before they arrive. These predictions then initiate actions that structure our worlds and alter the very things we need to engage and predict. Clark takes us on a journey in discovering the circular causal flows and the self-structuring of the environment that define "the predictive brain." What emerges is a bold, new, cutting-edge vision that reveals the brain as our driving force in the daily surf through the waves of sensory stimulation. (shrink)

In treating cognition as problem solving, Andy Clark suggests, we may often abstract too far from the very body and world in which our brains evolved to guide...

As Ruben notes, the macrostrategy can allow that the distinction may also be drawn at some micro level, but it insists that descent to the micro level is ...