In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

The complexity of biobank research raises concerns about individuals’ understanding of the information conveyed in the consent process for such research.. We report the results of a qualitative, cognitive interview study with an ethnically, linguistically, and educationally diverse sample of 43 respondents to assess the clarity and utility of a multimedia tool developed for a biobank. Using weighted randomization, respondents were assigned to either view the multimedia tool or read a written consent document . The study illustrates the utility of (...) cognitive interviews for gaining insights from prospective research participants about the clarity of informed consent tools. Findings suggest that a multimedia tool is useful for communicating key messages but should be combined with a written consent document and personal interaction with the study staff. We recommend that the potential value of multimedia tools should be more rigorously tested in a randomized controlled trial. (shrink)

The structure of natural languages is usually studied from three major different but interconnected points of view: syntax, semantics, and pragmatics. If we consider that the main purpose of natural languages is communication, we should consider another dimension for languages, which deals with the influence of internal states of communicating individuals on meanings. Such a dimension we refer to as internalism. Within this context, internalism cannot be confused with psycholinguistics, in the same way pragmatics cannot be confused with sociolinguistics. In (...) particular, we argue, language is tied to its systematic use. This view leads us to a non-realist perspective on linguistics. We analyze the role of natural languages into dialogues, by comparing our proposal to the dialogical approach to logic, which considers a dialogue as a game. Within our approach, there is no way to guarantee that two parties involved in a dialogue are playing the same game, due to unavoidable differences in their respective internal states. Another contribution of this paper is to argue that semantics plays a more fundamental role than syntax in the cognitive acquisition of languages. (shrink)

David Hume is one of the most provocative philosophers to have written in English. His Dialogues ask if a belief in God can be inferred from what is known of the universe, or whether such a belief is even consistent with such knowledge. The Natural History of Religion investigates the origins of belief, and follows its development from polytheism to dogmatic monotheism. Together, these works constitute the most formidable attack upon religious belief ever mounted by a philosopher. This new edition (...) includes Section XI of The Enquiry Concerning Human Understanding and a letter by Hume in which he discusses Dialogues. (shrink)

The role of chance in historiography is a major question for the analysis of cultural transformations. Its main subject are the transformations of contingentia itself, which has undergone substantial changes in its mythical forms (as Tyche or Fortuna) as well in its historical expressions in philosophy, theology, politics, sciences, literature and art.

The Three Papers comprising this series, together with my earlier [34] also published in this journal, constitute an attempt to set out the major issues in the theoretical domain of reduction and to develop a general theory of theory reduction. The fourth paper, [34], though published separately from this trio, is integral to the presentation and should be read in conjunction with these papers. Even so, the presentation is limited in scope – roughly, to intertheoretic reduction among empirical theories – (...) and informal in presentation – not least because a satisfying formal account of theories has yet to be offered. And despite the length, the treatment is still condensed; often corroborating and/or intuitively helpful detail has had to be consigned to footnotes or omitted. I approach the problem from within my own naturalistic realist philosophy of science and formal analysis of abstract hierarchy in theory. The sources for the former are [25], [29], [31], and [32] and those for the latter essentially [27] and [30]. Hierarchical notions played a significant role in the already published [34]. (shrink)

The role of interaction in learning is essential and profound: it must provide the means to solve open problems (those only vaguely specified in advance), but cannot be captured using our familiar formal cognitive tools. This presents an impasse to those confined to present formalisms; but interaction is fundamentally dynamical, not formal, and with its importance thus underlined it invites the development of a distinctively interactivist account of life and mind. This account is provided, from its roots in the interactivist (...) biological constitution of life, through the evolution of the dual internal regulatory capacities expressed as intentionality and intelligence, to its expression in self-directed anticipative learning in persons and in science. (shrink)

I argue that beliefs about what appears possible are justified in much the same way as beliefs about what appears actual. I do so by chisholming, and then modalizing, the epistemic principle associated with phenomenal conservatism. The principle is tested against a number of examples, and it gives the intuitively correct results. I conclude by considering how it can be used to defend two controversial modal arguments, a Cartesian argument for dualism and an ontological argument for the existence of God.

All the major inter-theoretic relations of fundamental science are asymptotic ones, e.g. quantum theory as Planck's constant h 0, yielding (roughly) Newtonian mechanics. Thus asymptotics ultimately grounds claims about inter-theoretic explanation, reduction and emergence. This paper examines four recent, central claims by Batterman concerning asymptotics and reduction. While these claims are criticised, the discussion is used to develop an enriched, dynamically-based account of reduction and emergence, to show its capacity to illuminate the complex variety of inter-theory relationships in physics, and (...) to provide a principled resolution to such persistent philosophical problems as multiple realisability and the nature of the special sciences. Introduction Exposition Examination I: Claims (1) and (2), asymptotic explanation and reference Examination II: Claim (3), reduction and singular asymptotics Examination III: Claim (4), emergence and multiple realisability Conclusion. (shrink)

It is now commonly accepted that N. Goodman's predicate "grue" presents the theory of confirmation of C. G. Hempel (and other such theories) with grave difficulties. The precise nature and status of these "difficulties" has, however, never been made clear. In this paper it is argued that it is very unlikely that "grue" raises any formal difficulties for Hempel and appearances to the contrary are examined, rejected and an explanation of their intuitive appeal offered. However "grue" is shown to raise (...) an informal, "over-arching" difficulty of great magnitude for all theories of confirmation, including Hempel's theory. (shrink)

It is no longer possible to claim that the biological characteristics of the future adult are already determined at conception. After all, a zygote may develop into a hydatidiform mole rather than into a human being. The development of an individual human person is determined by genetically and nongenetically coded molecules within the embryo, together with the influence of the maternal environment. Consequently, it is an error to regard the zygote's chromosomal (and other) DNA as sufficient to determine the uniqueness (...) of the future individual. (shrink)

This book seeks to examine the mutual interplay between existentialism and Christian belief as seen through the work of three existentialist thinkers who were also committed Christians - a Spaniard, a Russian, and a Frenchman. They are compared with each other and with leading non-religious existentialists. The major themes studied include reason, freedom, the self, belief, hope, love, suffering, and immortality.

C A Wringe; Pupils’ Rights, Journal of Philosophy of Education, Volume 7, Issue 1, 30 May 2006, Pages 103–115, https://doi.org/10.1111/j.1467-9752.1973.tb00475.

This essay outlines the moral dilemma of funding orphan drug research and development. To date, ethical aspects of priority setting for research funding have not been an issue of discussion in the bioethics debate. Conflicting moral obligations of beneficence and distributive justice appear to demand very different levels of funding for orphan drug research. The two types of orphan disease, rare diseases and tropical diseases, however, present very different ethical challenges to questions about allocation of research funds. The dilemma is (...) analysed considering utilitarian and rights based theories of justice and moral obligations of non-abandonment and a professional obligation to advance medical science. The limitations of standard economic evaluation tools and other priority setting tools used to inform health policy decision makers on research funding decisions are outlined. (shrink)

The question of churches resorting to the courts to influence public policy is one that concerns the appropriate role of the courts and the appropriate conduct of religious authorities. I agree with Skene and Parker that there is no principled legal reason to exclude such interventions out of hand; but my comments are principally addressed to the political and religious reasons for being rightly concerned about such activity. These advert both to the nature of the liberal democratic compromise and to (...) the nature and scope of religious authority. (shrink)

Part I of this trilogy, Historical and Scientific Setting, set out a general context for selecting a certain subclass of inter-theoretic relations as achieving appropriate explanatory and ontological unification – hence for properly being labelled reductive. Something of the complexity of these relations in real science was explored. The present article concentrates on the role which identity plays in structuring the reduction relation and so in achieving ontological and explanatory unification.

In this response to Jonny Anomaly’s ‘Is Obesity a Public Health Problem?’ I argue, contra the author that public health actually increases individuals’ abilities to choose actions that further their health goals, specifically in the case of obesity. The intractability of obesity as an individual medical problem combined with the health benefits of modest (5–10 per cent of body weight) weight loss suggest that public health measures helping people make small changes in eating habits improve population health. I argue that (...) such measures are available to public health via behavioral economic research and policy proposals from libertarian paternalists. I respond to author’s claim that obesity does not constitute a public health problem because: (i) it is not an epidemic and (ii) obesity reduction is not a public good. I argue that epidemic status is not required for classification as a public health problem, but that obesity does have the status of an epidemic. I also point out flaws in author’s reasoning about obesity, public health and social costs. I conclude by suggesting that public health, in partnership with stakeholders and other areas of government, is poised to help create conditions for modest weight loss and increased population health overall. (shrink)

Contrary to the Empiricist model of science, successful sufficiently fundamental theories not only fit and unify their data fields but also prescribe the general terms in which relevantly to describe observation; specify what is and is not observable; specify the conditions under which what is observable, is observable; specify the instrumental means and reliability by which what is measurable is measured; specify what is causally, statistically, and merely accidentally connected. Moreover, such theories typically require all or most of the entire (...) remainder of science to be properly applied in any given situation and theoreticians' models play a crucial role in such applications. (I call these respectively the internal and external globalnesses of theories.) A discussion of the consequences of these global features of theories for philosophy of science is offered in the context of specific examples and a structural model for science. (shrink)

It is a theorem of Prikry [7] that ifκcarries a uniformη-descendingly complete ultrafilter then the stationary reflection propertyfails. In this paper we will derive similar results, but here from properties of filters rather than ultrafilters.Throughoutκandηwill denote regular cardinals withη<κ, andIwill denote an ideal onκ, by which we mean a setI⊆P such that Iis closed under taking subsets and finite unions and αЄIfor eachα<κ, butκ∉I.Iis said to beμ-complete if it is closed under taking unions of size <μ,I* = {X⊆κ∣κ−XЄI} is the (...) filter dual toIand ifAЄI+ −I), thenI∣Ais the ideal onκgiven byI∣A= {X⊆κ∣X∩AЄI}. Ifh: A→κthenhis said to be unbounded modIif for eachα<κ,h−1 = {ξЄA∣h<α} ЄIand a least function forIifhis unbounded modIand wheneverg: A→κis a function, unbounded modI, then {ξЄA∣g{ξ) shrink)

The issue of power has been addressed as part of human actions, which form the basis of the discussions of destiny in Islamic theology. Various schools of kalām have extensively discussed the issue of power throughout history. The locus of power is also one of the critical concerns that have been emphasized within these discussions. The schools of the Mu'tazila, al-Ashʿarī and al-Māturīdī have put forward different perspectives on whether the locus of power exists or not and where it exists (...) if it does so. Mutazilites are known to be in agreement with the view that te human body is the substrate of power. On the other hand, However, they hold different views, not only on the exact locus of power in the body but also on its type. While some argue that the locus of power in the body is the organs, others claim that it is not the organs. The schools of al-Ashʿarī and al-Māturīdī accept that there is no locus for power and emphasize that power is created by Allah the moment it would initiate action. When these views of the kalām schools are considered within the framework of the data from the modern science of anatomy, it is seen that what modern science has to say on this issue concurs well with the Mu'tazilite view that the locus of power is the body and that it creates the action by managing the organs from a single center. This is because, when considered from the lens of anatomy, what is meant by the schools of kalām with “power” is electrical activity (stimulus) that activates the muscles. Therefore, scientifically considered, for any movement to occur, an electrical activity must first begin in the brain and be transmitted to the muscles via motor nerves. If there were no electrical activity in the brain, the muscles and energy that make up the human movement system would not be active, so movement would hardly take locus. Therefore, the claim made some of the Mu'tazili scholars that the power is in the organs is scientifically not valid. As for the debates on whether the power in different organs is the same or different in terms of its type, the views of the scholars who argue that they are the same genus are apparently correct. This is because the electrical activity, which we accept as power, spreads to the organs after it is formed in the brain. This implies that the power which activates the organs is of the same type. However, it can be said that Mu'tazila’s idea of the constant presence of power in its locus conflicts with modern scientific data. The views of al-Ash'arite and al-Maturidite schools that power is free from being in a constant location are compatible with the findings of recent experiments on brain activities. That is, some experimental studies have indicated that the electrical activity that creates an act occurs in the brain before the act itself and outside the will of the human. In brief, the view of Ash'arite and Maturidite scholars that power is not constantly present in the body and that it is created by Allah each time it is needed is compatible with the creation of power, which we define as electrical activity. (shrink)

Coady explores the challenges that morality poses to politics. He confronts the complex intellectual tradition known as realism, which seems to deny any relevance of morality to politics, especially international politics. He argues that, although realism has many serious faults, it has lessons to teach us: in particular, it cautions us against the dangers of moralism in thinking about politics and particularly foreign affairs. Morality must not be confused with moralism: Coady characterizes various forms of moralism and sketches their distorting (...) influence on a realistic political morality. He seeks to restore the concept of ideals to an important place in philosophical discussion, and to give it a particular pertinence in the discussion of politics. He deals with the fashionable idea of "dirty hands," according to which good politics will necessarily involve some degree of moral taint or corruption. Finally, he examines the controversial issue of the role of lying and deception in politics. Along the way Coady offers illuminating discussion of historical and current political controversies. This lucid book will provoke and stimulate anyone interested in the interface of morality and politics. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work.This work is in the public domain in (...) the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

When Huck Finn embarks upon his hilarious education of the slave Jim in the moral vagaries of the monarchies of Europe, he takes himself to be propounding the merest common sense. He may have thought large‐scale villainy restricted to autocracies, but his creator was clearly not so naive. More to the present point, Huck ends his discourse on princely rule with remarks that show he was not merely cataloguing the fact of widespread royal vice, but willing to countenance it as (...) necessary. As he puts it, ‘kings is kings, and you got to make allowances. Take them all around, they're a mighty ornery lot’. (shrink)