There are several good reasons for the UK Department of Health to recommend the appraisal of bevacizumab for the treatment of eye conditions by the National Institute for Health and Clinical Excellence. These reasons will extend to other drugs when similar situations arise in the future.

There is a vast literature within philosophy of mind that focuses on artificial intelligence, but hardly mentions methodological questions. There is also a growing body of work in philosophy of science about modeling methodology that hardly mentions examples from cognitive science. Here these discussions are connected. Insights developed in the philosophy of science literature about the importance of idealization provide a way of understanding the neural implausibility of connectionist networks. Insights from neurocognitive science illuminate how relevant similarities between models and (...) targets are picked out, how modeling inferences are justified, and the metaphysical status of models. (shrink)

During public health crises including the COVID-19 pandemic, resource scarcity and contagion risks may require health systems to shift—to some degree—from a usual clinical ethic, focused on the well-being of individual patients, to a public health ethic, focused on population health. Many triage policies exist that fall under the legal protections afforded by “crisis standards of care,” but they have key differences. We critically appraise one of the most fundamental differences among policies, namely the use of criteria to categorically exclude (...) certain patients from eligibility for otherwise standard medical services. We examine these categorical exclusion criteria from ethical, legal, disability, and implementation perspectives. Focusing our analysis on the most common type of exclusion criteria, which are disease-specific, we conclude that optimal policies for critical care resource allocation and the use of cardiopulmonary resuscitation (CPR) should not use categorical exclusions. We argue that the avoidance of categorical exclusions is often practically feasible, consistent with public health norms, and mitigates discrimination against persons with disabilities. (shrink)

Philosophical discussion of truthmaking has flourished in recent times, but what exactly does it mean to ‘make’ a truth-bearer true? I argue that ‘making’ is a concept with modal force, and this renders it a problematic deployment for truthmaker theorists with nominalist sympathies, which characterises most current theories. I sketch the outlines of what I argue is a more genuinely realist truthmaker theory, which is capable of answering the explanatory question: In virtue of what does each particular truthmaker make its (...) particular truthbearer(s) true? I do this by drawing on recent work by Frederik Stjernfelt on Charles Peirce’s account of the proposition as having a ‘particular double structure’, according to which a proposition not only depicts certain characters of an object, it also depicts itself claiming those characters to pertain to the object. This double structure, I shall argue, also resolves important issues in analytic philosophers’ truthmaker theory, including the proper distinction between reference and truthmaking, and a dilemma concerning an infinite regress of truthmaking. (shrink)

Talents often play a significant role in our personal and social lives. For example, our talents may shape the choices we make and the goods that we value, making them central to the creation of a meaningful life. Differences in the level of talents also affect how social institutions are structured, and how social goods and resources are distributed. Despite their normative importance, it is surprising that talents have not yet received substantial philosophical analysis in their own right. As a (...) result, the current literature is rife with conceptual ambiguity: a talent is referred to as all of a skill, potential, ability, capacity, endowment, and a natural gift. In response to this confusion, in this paper I develop an account of what a talent is, based on the debate concerning the metaphysics of ability and dispositions. I argue for a position that I call ‘talent dispositionalism’: S has a talent for skill A in circumstances C iff S has the general disposition to excellently develop and maintain A when, in circumstances C, she tries to excellently develop and maintain A. On this account, a talent is not the skill itself, but a general iterated ability for the excellent development and up-keep of a particular skill, constituted by an agent’s dispositional properties. I defend the account against four objections usually levelled against traditional dispositionalist theories of ability, and highlight some ways the account may influence debates in other areas of philosophical inquiry. (shrink)

Tetris provides a difficult, dynamic task environment within which some people are novices and others, after years of work and practice, become extreme experts. Here we study two core skills; namely, choosing the goal or objective function that will maximize performance and a feature-based analysis of the current game board to determine where to place the currently falling zoid so as to maximize the goal. In Study 1, we build cross-entropy reinforcement learning models to determine whether different goals result in (...) different feature weights. Two of these optimization strategies quickly rise to performance plateaus, whereas two others continue toward higher but more jagged heights. In Study 2, we compare the zoid placement decisions made by our best CERL models with those made by 67 human players. Across 370,131 human game episodes, two CERL models picked the same zoid placements as our lowest scoring human for 43% of the placements and as our three best scoring experts for 65% of the placements. Our findings suggest that people focus on maximizing points, not number of lines cleared or number of levels reached. They also show that goal choice influences the choice of zoid placements for CERLs and suggest that the same is true of humans. Tetris has a repetitive task structure that makes Tetris more tractable and more like a traditional experimental psychology paradigm than many more complex games or tasks. Hence, although complex, Tetris is not overwhelmingly complex and presents a right-sized challenge to cognitive theories, especially those of integrated cognitive systems. (shrink)

The observation that concepts used by social scientists are often problematic is not new; they have been described as Ballung concepts, cluster concepts, essentially contested, and reflexive; however, the need to work with these concepts remains. This article addresses the problem of variable choice in the social sciences by exploring and extending Woodward’s recommendations. This article demonstrates why Woodward’s criteria are difficult to apply in the social sciences and proposes an alternative, but complementary, framework for assessing variables.

This article describes and evaluates the application of an explicitly critical realist methodology to a quantitative doctoral research project on the causes of family homelessness in Australia. It...

In this paper, I argue for an account of metaphorical content as what is said when a speaker utters a metaphor. First, I show that two other possibilities—the Gricean account of metaphor as implicature and the strictly semantic account developed by Josef Stern—face several serious problems. In their place, I propose an account that takes metaphorical content to cross-cut the semantic-pragmatic distinction. This requires re-thinking the notion of metaphorical content, as well as the relation between the metaphorical and the literal.

Relevance Theory is a cognitively oriented theory of pragmatics, i.e., a theory of language use. It builds on the seminal work of H.P. Grice1 to develop a pragmatic theory which is at once philosophically sensitive and empirically plausible (in both psychological and evolutionary terms). This entry reviews the central commitments and chief contributions of Relevance Theory, including its Gricean commitment to the centrality of intention-reading and inference in communication; the cognitively grounded notion of relevance which provides the mechanism for explaining (...) pragmatic interpretation as an intention-driven, inferential process; and several key applications of the theory (lexical pragmatics, metaphor and irony, procedural meaning). Relevance Theory is an important contribution to our understanding of the pragmatics of communication. (shrink)

Precision medicine research is rapidly taking a lead role in the pursuit of new ways to improve health and prevent disease, but also presents new challenges for protecting human subjects. The extent to which the current “web” of legal protections, including technical data security measures, as well as measures to restrict access or prevent misuse of research data, will protect participants in this context remains largely unknown. Understanding the strength, usefulness, and limitations of this constellation of laws, regulations, and procedures (...) is critical to ensuring not only that participants are protected, but also that their participation decisions are accurately informed. To address these gaps, we conducted in-depth interviews with a diverse group of 60 thought-leaders to explore their perspectives on the protections associated with precision medicine research. (shrink)

This article examines two contrasting interviews—with an Anglo and a Puerto Rican woman—and concludes that gender congruence does not help an Anglo interviewer make sense of the working-class, Hispanic woman's account of her marital separation. Both in form and content, her discourse contrasts sharply with an Anglo woman's account. The two women use different narrative genres or forms of telling to communicate their culturally distinctive experiences with marriage. In the case of the Puerto Rican woman, these differences result in major (...) misunderstandings by the interviewer. Applying narrative methods to these interviews shows how closer attention to the voice of the subject can enrich qualitative research. (shrink)

In the care of patients with disorders of consciousness (DOC), some ethical difficulties stem from the challenges of accurate diagnosis and the uncertainty of prognosis. Current neuroimaging research on these disorders could eventually improve the accuracy of diagnoses and prognoses and therefore change the context of end-of-life decision making. However, the perspective of healthcare professionals on these disorders remains poorly understood and may constitute an obstacle to the integration of research. We conducted a qualitative study involving healthcare professionals from an (...) acute care university medical center. A short questionnaire captured demographic data as well as the experience of participants with DOC patients. A semi-structured interview was used to explore attitudes toward ethical issues identified in a previous literature review. Qualitative content analysis of interviews was conducted with the NVivo software. Accurate diagnosis among DOC is often regarded as a challenge, but this was generally not the case for our participants because most reported high confidence in DOC diagnoses. However, participants reported struggling with prognosis, especially because of its essential role for end-of-life decision making and communication with families. Variability of opinion between healthcare professionals was reported and identified by some as a minor issue while others stressed how families struggle with different medical opinions. End-of-life decision making encompassed a large proportion of ethical challenges in these patients, and the removal of artificial nutrition and hydration created significant discomfort in a minority of participants. The concept of futility was subject to wide-ranging understandings with both favorable and unfavorable opinions. Our data suggest that to ensure the incorporation of new evidence-based advances, attention should be directed to the real-world practices and challenges of accurate diagnosis and prognosis. Given pervasive challenges in end-of-life care, we recommend improved training of healthcare professionals in the care of patients with DOC, particularly in end-of life care, understanding the context of decision making, and determining how to optimally integrate new neuroscience research on the care of patients with DOC. (shrink)

As doctoral students from New Zealand and Australia, advised by supervision teams with a diversity of critical realist experience from limited to none, we came independently to the 2018 Critical Re...

Photography has become a pervasive component of contemporary communication. Recent technological advances in creating and manipulating images have provided renewed impetus to decades-long debates on use of photographs in science. With increase in the potential for inappropriate image manipulation, fears about misrepresentation have heightened concern among journal editors and scholars about the 'accuracy' of published images. We discuss how science has responded to growing concerns surrounding falsification and inaccuracy of photography. We document progress in implementing a variety of complementary approaches (...) to addressing the problem. These include digital forensics, photo member checking and the implementation of codes of ethics to enhance the veracity of published photographs in science research. We conclude by acknowledging the irreducible conflict likely to remain between use of the photograph as a creative work of art and employment of this medium as a source of information in the progress of science. (shrink)

In this paper I examine the meaning of physical touch as it occurs in the nurse–patient interaction. There are two aspects of the nurse–patient relationship that are found in most nurse–patient interactions which together have profound implications for nurses as practitioners and as individual human persons. The first is the clinical intimacy of the nurse–patient relationship where nurses touch, rub, smooth, clean, dress and otherwise physically interact with patients. The other is the existential crisis, the possibility of loss, suffering and (...) death that lurks at the horizon of most, if not all, healthcare encounters. Edmund Husserl, Merleau‐Ponty and more recently Robert Sokolowski argue that tactile sensations and resultant perceptions are fundamental to all sensory perception. Further, they argue that tactile sensation is fundamental for the ongoing constitution of ‘my’ self as a person and for the development and exercise of human intersubjectivity. If tactile interaction is crucial to the development of our very selves as persons and a significant aspect of our interaction with patients includes direct or observed tactile sensations and if further these sensations occur around the context of existential crises for our patients, then nurse's very selves as persons are being challenged by these interactions. Here, then I examine the philosophical argument for the role of tactile sensations in our human development and briefly look at contemporary neurophysiologic research that supports this philosophical account. I then suggest ways such physical intimacy can lead to a strengthening or weakening of the person of the nurse and the nursing interaction and end with some thoughts about ways to support nurses in these activities. (shrink)

This article explores a problem of the articulation of an adequate account of the human person in both philosophical and nursing theory. It follows the lead of philosopher Norris Clarke in suggesting that there has been a significant division in the way philosophers have looked at the human person and goes on to suggest that this division is paralleled in prominent nursing theories. The paper reviews and argues for the synthesis of two contemporary philosophic theories of the person that arise (...) from the traditional philosophical division, and uses Clarke's account to show the ontological need for such a synthesis if we are to have a more adequate account of the human person. Next, accounts of the person identified in a number of the prominent theories of nursing are briefly reviewed revealing the vast complexity of the person encountered in nursing practice. It is suggested that each new theory of nursing is founded, at least in part, on the need to account for attributes of the person missing from prior nursing theories. It will be seen that the synthesized account of the person argued for here more adequately accounts for the various attributes identified in these nursing accounts and it is hoped that this synthesized account will serve as a somewhat more complete basis for a continued exploration of the persons encountered in nursing practice in its many and varied manifestations. (shrink)

An understanding of the nature and development of nursing intuition can help nurse educators foster it in young nurses and give clinicians more confidence in this aspect of their knowledge, allowing them to respond with greater assurance to their intuitions. In this paper, accounts from philosophy and neurophysiology are used to argue that intuition, specifically nursing intuition, is a valid form of knowledge. The paper argues that nursing intuition, a kind of practical intuition, is composed of four distinct aspects that (...) include: embodied knowledge rather like that knowledge we have when we have learned to ride a bicycle; well‐trained sensory perceptions attentive to subtle details of complex, often rapidly changing situations; a significant store of pertinent conceptual knowledge; and a history of habitual actions intentionally directed towards achieving the best outcomes for our patients. Contemporary neurophysiology research strongly suggests that human persons experience other persons such that they directly understand the meaning of a variety of different human actions, intentions, emotions, and sensations in immediate, non‐reflective, and non‐conceptual perceptions. This research is supported by the philosophical theories of Jacques Maritain and Yves R. Simon found in their accounts of practical knowledge. Together, these accounts offer us a rich view of the reality of nursing intuition that helps us understand why we find intuitive actions in some but not all nurses and gives us some specific information about how to develop intuition in young nurses. Finally, this research shows us a path for further research. (shrink)

Counterpath is a collaborative work by Catherine Malabou and Jacques Derrida that answers to the gamble inherent in the idea of “travelling with” the philosopher of deconstruction. Malabou's readerly text of quotations and commentary demonstrates how Derrida's work, while appearing to be anything but a travelogue, is nevertheless replete with references to geographical and topographical locations, and functions as a kind of counter-Odyssey through meaning, theorizing, and thematizing notions of arrival, drifting, derivation, and catastrophe. In fact, by going straight (...) to the heart of the Derridean idea of “spacing,” she finally makes it seem as though Derrida has never written about anything but travel. Malabou's text is punctuated by a series of postcards received by Derrida from destinations such as Istanbul and Porto, Laguna Beach and Athens, which are inspired by his reading of her evolving discussion. Writing in a familiar and unguarded manner, as if he were “on vacation” from his own writing, Derrida still remains totally faithful to that work and invites the reader to reflect on much of what haunts his texts as well as his daily life, questions of distance and death, the relation to the other, and exile. (shrink)

Drawing on fieldwork and interviews from South India, the author analyzes married women's experiences of stigma when they are childless and their everyday resistance practices. As stigma theory predicts, childless women deviate from the “ordinary and natural” life course and are deeply discredited, but contrary to Goffman's theory, South Indian women cannot “pass” or selectively disclose the “invisible” attribute, and they make serious attempts to destigmatize themselves. Social class and age mediate stigma and resistance processes: Poor village women of childbearing (...) age are devalued in ways affluent and professional women avoid; differently situated women challenge dominant definitions and ideologies of family in distinctive ways. South Indian women are creating spaces for childless marriages within the gendered margins of families and culturally prevalent definitions of womanhood. The findings contribute to rethinking Western assumptions in Goffman's theory and suggest new directions for research on power and everyday resistance. (shrink)

The centuries-old art of spiritual direction continues to be crafted by those who willingly serve as spiritual mentors for countless spiritual seekers who feel drawn by God's grace to engage in the transformative process of spiritual formation. The work of this article offers an in-depth consideration of the spiritual guidance offered by two outstanding spiritual guides, Ignatius of Loyola in his 16th century spiritual manual, The Spiritual Exercises, and Dallas Willard in his recent spiritual book, Renovation of the Heart. After (...) establishing the historical and contextual frameworks needed for getting to know each of our spiritual guides, significant attention will be then given to the exploration of five key spiritual movements that can effectively serve as unifying threads for our consideration of the work of our spiritual transformation into Christ-likeness. (shrink)

“Act so that the effects of your action are compatible with the permanence of genuine human life on Earth.” How can we understand Jonas’ “maxim”? Is it too anthropocentric to be of any interest for an environmental ethic? Is is too limited to survival to have a moral signification in a truly human ethic? One can argue first that it is not so much anti-Kantian than that it challenges the current prevailing “presentism” and obliges us to take into consideration not (...) only future generations, but also the context in which one anticipates these future generations to be living. Therefore, we can distinguish two different interpretations of Jonas’ maxim: in a first stage, that of sustainable development, it was understood as taking into consideration not only the needs but also the rights of future generations; in a second stage, that of an Anthropocene and ecological transition, it means that making sense of humanity implies connecting human beings to the Earth and other living beings far from opposing them. (shrink)

Newton’s famous Hypotheses non fingo raises many questions. While he castigated the Cartesians for their vortex hypothesis, and his follower Cotes attacked mechanical chemistry, Newton himself ventured many hypotheses, notably in his Opticks, the Queries to the Opticks and in the last book of the Principia. Although it is true that Newton, unlike Descartes, fit his data to mathematical models, what he said about hypotheses seems straightforwardly false. To explain this situation, Wilson explores the web of associations between Cartesianism, hypotheses, (...) ‘speculation’ and ‘vain philosophy’ in the Pauline sense. She shows how Cartesian hypotheses concerning the origins of the world were understood as dangerously pagan, and how Newton and his supporters took pains to distinguish their brand of science from his by denying that they were engaged in any form of speculative or ‘vain’ philosophy. (shrink)

_Shohei Imamura_ Edited by James Quandt Toronto: Toronto International Film Festival Group, 1997 ISBN 0-9682969-0-4 183 pp.

Cet article se propose d’examiner le concept de « douleur transcendantale » développé par Heidegger dans le volume 68 de la ‘‘ Gesamtausgabe ’’intitulé ‘‘ Hegel’’. Comment une douleur peut-elle être dite ‘‘ transcendantale ’’en général? Cette question en effet à Heidegger d’affirmer que la négativité hégélienne a une double expression, logique et phenoménologique et n’est donc pas une pure abstraction.

In a world surrounded by smart objects from sensors to automated medical devices, the ubiquity of ‘smart’ seems matched only by its lack of clarity. In this article, we use our discussions with expert stakeholders working in areas of implantable medical devices such as cochlear implants, implantable cardiac defibrillators, deep brain stimulators and in vivo biosensors to interrogate the difference facets of smart in ‘implantable smart technologies’, considering also whether regulation needs to respond to the autonomy that such artefacts carry (...) within them. We discover that when smart technology is deconstructed it is a slippery and multi-layered concept. A device’s ability to sense and transmit data and automate medicine can be associated with the ‘sting’ of autonomy being disassociated from human control as well as affecting individual, group, and social environments. (shrink)

In its governance activities for genetic resources, the international community has adopted various approaches to their ownership, including: free access; common heritage of mankind; intellectual property rights; and state sovereign rights. They have also created systems which combine elements of these approaches. While governance of plant and animal genetic resources is well-established internationally, there has not yet been a clear approach selected for human genetic resources. Based on assessment of the goals which international governance of human genetic resources ought to (...) serve, and the implications for how they will be accessed and utilised, it is argued that common heritage of mankind will be the most appropriate approach to adopt to their ownership/control. It does this with the aim of stimulating discussion in this area and providing a starting point for deeper consideration of how a common heritage of mankind, or similar, regime for human genetic resources would function and be implemented. (shrink)

ABSTRACTHume was not a philosopher famed for what are sometimes called ‘ontological commitments'. Nevertheless, few contemporary scholars doubt that Hume was an atheist, and the present essay tenders the view that Hume was favourably disposed to the 'vital materialism' of post-Newtonian natural philosophers in England, Scotland and France. Both internalist arguments, collating passages from a range of Hume's works, and externalist arguments, reviewing the likely sources of his knowledge of ancient materialism and his association with his materialistic contemporaries are employed.

This article examines the limitations of the sociological research on feminist identities and ideologies that ignores the intersection of race and gender. Drawing from multiracial feminist theorizing, the author asks, Is self-identification as feminist a biased indicator of the salience of feminism in African American women's lives? Do women's racial statuses mediate the relationship between particular life events and experiences and the extent to which they embrace feminism? and To what extent are racial differences important when considering what women understand (...) feminism to be? To answer these questions, the author conducted multiple group analyses of structural equation models to analyze data from the 1996 General Social Survey. Her findings are consistent with multiracial feminist theories and suggest a need to rethink traditional approaches to feminist research so that women's differences are no longer marginalized. (shrink)

The financial crisis has led to calls for increased regulation of the financial sector. In many respects this is uncontroversial because increased regulation should promote the behaviours we want to see, while limiting the behaviours we do not. This article takes issue with the idea that regulation, and guidelines, promote ethical behaviour in the way that we want them to. Firstly, judgement is often required to implement guidelines and regulations, which allows room for unethical behaviour. Secondly, we want financial professionals (...) to behave ethically even when there are significant incentives not to; so, verifying compliance with regulations and guidelines when such incentives are absent isn’t a good gauge of the ethical status of financial professionals. -/- The example of the valuation of the assets (Net Asset Value) of hedge funds illustrates these issues well. There are many rules governing how NAVs should be calculated, and while we can verify that a fund is abiding by the rules, the ability to manipulate the NAV remains. Furthermore, the incentive to do so is often only present during a crisis (usually to understate losses). Therefore, verifying compliance during ‘normal’ times is of little help in judging whether a manager will behave ethically when we most need him to. I first argue that the gap between compliance with regulations and ethical behaviour is best filled by the adoption of a virtue ethics approach, as discussed by Spalding & Oddo (2011), and Graafland & van de Ven (2011). I then discuss the implications of adopting such an approach for the financial industry’s codes of conduct, such as the CFA Institute’s ‘Code of Ethics and Standards of Professional Conduct’. Adopting a virtue ethics perspective would require a significant change in the emphasis of such codes. (shrink)

Multidisciplinary Perspectives on the Donation of Stem Cells and Reproductive Tissue Content Type Journal Article Category Symposium Pages 15-17 DOI 10.1007/s11673-011-9351-x Authors Catherine Waldby, School of Social and Political Sciences, University of Sydney, Sydney, Australia Ian Kerridge, Centre for Values, Ethics and the Law in Medicine, Medical Foundation Building (K25), University of Sydney, Sydney, NSW 2006, Australia Loane Skene, Faculty of Law and Faculty of Medicine, Dentistry and Health Studies, University of Melbourne, Melbourne, VA, Australia Journal Journal of Bioethical (...) Inquiry Online ISSN 1872-4353 Print ISSN 1176-7529 Journal Volume Volume 9 Journal Issue Volume 9, Number 1. (shrink)

On étudie ici les monnaies dans lesquelles sont évaluées les dépenses et les recettes de l'hipparque thébain Pompidas, v. 170/150 : les drachmes ἀργυρίου συμμαχικού et les drachmes χαλκού. À en juger par la chronologie des inscriptions béotiennes du dossier de l'ἀργύριον συμμαχικόν de la basse époque hellénistique, c'est probablement dans une alliance constituée lors des conflits de la fin du IIIe s. qu'il faut rechercher l'origine de cette expression qui désigne l'étalon éginétique réduit; la Symmachie Hellénique formée en 224/3 (...) est une candidate possible. Des monnaies de bronze béotiennes qui circulaient à l'époque de l'inscription ont des types analogues à ceux des drachmes contemporaines ; le taux élevé de l'agio du change des pièces d'argent en pièces de bronze dans l'inscription autant que la documentation relative aux conséquences financières de la disette du 1er quart du IIe s. en Béotie invitent à se demander si certaines pièces de bronze béotiennes n'avaient pas à cette époque une valeur d'espèce habituellement frappée en argent. (shrink)

The spillovers in knowledge among largely college-educated workers were among the key reasons for the impressive degree of economic growth and spread of entrepreneurship in the United States during the 1990s. Prior 'industrial policies' in the 1970s and 1980s did not advance growth because these were based on outmoded large manufacturing models. Zoltan Acs and Catherine Armington use a knowledge spillover theory of entrepreneurship to explain new firm formation rates in regional economies during the 1990s period and beyond. The (...) fastest-growing regions are those that have the highest rates of new firm formation, and which are not dominated by large businesses. The authors of this text also find support for the thesis that knowledge spillovers move across industries and are not confined within a single industry. As a result, they suggest, regional policies to encourage and sustain growth should focus on entrepreneurship among other factors. (shrink)

Talitha Cooreman-Guittin et Catherine Vialle Cet article pose une question nouvelle : Y a-t-il dans la Bible un biais « validiste » contre les femmes porteuses de handicap? Les auteures répondent par un prudent « oui, mais… ». Toutefois, la réception des textes qui évoquent des situations de handicap commence à changer. Cette étude est une illustration de ce changement en cours.