This essay takes the concept of “digital ekphrasis” as an opportunity to look at contemporary multimodal AI – or more precisely text-to-image generators, understood as the latest phenomena in the media history of technical images. In my discussion, I raise the question of whether the digitally programmed image generation performed by programs like Stable Diffusion, Midjourney or DALL-E can be thought of as ekphrasis. Following recent discussions in the field of media theory, I thereby ask whether the criterion of operativity (...) is decisive for distinguishing text-to-image generation from ekphrasis in the classical sense. My discussion evolves in a revision of ekphrasis in the art historical sense, confronted with the structural processes of multimodal AI. However, the comparison of these two modes of ekphrasis reveals how impoverished the concepts of both image and language risk being in the context of text-to-image-modelling. This, in turn, does not mean that current AI imageries cannot be discussed regarding a (post-) digital aesthetics. Rather, as recent media artists working with multimodal AI show, text-to-image reformulates old questions about the relationship between art or aesthetics and (media) technology. (shrink)

To commemorate 40 years since the founding of the Journal of Business Ethics, the editors in chief of the journal have invited the editors to provide commentaries on the future of business ethics. This essay comprises a selection of commentaries aimed at creating dialogue around the theme Ethics at the centre of global and local challenges. For much of the history of the Journal of Business Ethics, ethics was seen within the academy as a peripheral aspect of business. However, in (...) recent years, the stakes have risen dramatically, with global and local worlds destabilized by financial crisis, climate change, internet technologies and artificial intelligence, and global health crises. The authors of these commentaries address these grand challenges by placing business ethics at their centre. What if all grand challenges were framed as grand ethical challenges? Tanusree Jain, Arno Kourula and Suhaib Riaz posit that an ethical lens allows for a humble response, in which those with greater capacity take greater responsibility but remain inclusive and cognizant of different voices and experiences. Focussing on business ethics in connection to the grand challenge of environmental emergencies, Steffen Böhm introduces the deceptively simple yet radical position that business is nature, and nature is business. His quick but profound side-step from arguments against human–nature dualism to an ontological undoing of the business–nature dichotomy should have all business ethics scholars rethinking their “business and society” assumptions. Also, singularly concerned with the climate emergency, Boudewijn de Bruin posits a scenario where, 40 years from now, our field will be evaluated by its ability to have helped humanity emerge from this emergency. He contends that Milieudefensie v. Royal Dutch Shell illustrates how human rights take centre stage in climate change litigation, and how business ethics enters the courtroom. From a consumer ethics perspective, Deirdre Shaw, Michal Carrington and Louise Hassan argue that ecologically sustainable and socially just marketplace systems demand cultural change, a reconsideration of future interpretations of “consumer society”, a challenge to the dominant “growth logic” and stimulation of alternative ways to address our consumption needs. Still concerned with global issues, but turning attention to social inequalities, Nelarine Cornelius links the capability approach to global and corporate governance, arguing that CA will continue to lie at the foundation of human development policy, and, increasingly, CSR and corporate governance. Continuing debate on the grand challenges associated with justice and equality, Laurence Romani identifies a significant shift in the centrality of business ethics in debates on managing differences, positing that dialogue between diversity management and international management can ground future debate in business ethics. Finally, the essay concludes with a commentary by Charlotte Karam and Michelle Greenwood on the possibilities of feminist-inspired theories, methods, and positionality for many spheres of business ethics, not least stakeholder theory, to broaden and deepen its capacity for nuance, responsiveness, and transformation. In the words of our commentators, grand challenges must be addressed urgently, and the Journal of Business Ethics should be at the forefront of tackling them. (shrink)

Charlotte Wolff was born in Riesenburg, West Prussia into a middle-class Jewish family. She studied philosophy and then medicine at several German universities, completing her doctorate in Berlin in 1926. Working in various institutions over the next few years, she was also interested in psychotherapy and had a small private medical and psychotherapeutic practice. In 1933 she was forced to leave Germany because of the Nazi regime, and settled for a few years in Paris. As a German refugee she (...) was unable to practice medicine, so she began her research into the correlation between hand traits and personality. In 1936 she went to London to continue her research work and lived there until her death. An active lesbian from an early age, her later research turned to sexology and her writing on lesbianism and bisexuality were influential early works in the field. This is a great opportunity to rediscover her early work, including her first autobiography. (shrink)

Individual differences in children's talk about inner states are striking, but how should they be interpreted? This study used transcripts of preschoolers’ conversations with siblings and best friends to address this question in two ways. Our first aim was to elucidate the exact nature of individual differences by contrasting categories (emotion/desire vs. cognitive state) and referents (own vs. other/shared) of inner state talk. Our second aim was to compare performance vs. competence views of inner state talk by exploring (i) the (...) stability of individual differences in inner state talk across different relationships and (ii) the cognitive correlates of inner state talk. A sample of 44 children (mean age = 4 years 3 months) was observed for 20 minutes at home playing with a sib and for 20 minutes at school playing with a best friend. Videos were transcribed and coded for the frequency and form of inner state talk (e.g., talk about different categories of inner state, or about own vs. others’ inner states). During the school visits, children completed a set of tasks tapping theory-of-mind skills and verbal ability. Individual differences in inner state talk (especially reference to others’ inner states) were stable across relationships. There was no association between individual differences in talk about cognitive vs. emotion/desire states, although both categories of inner state talk were significantly associated with individual differences in children's theory-of-mind skills. (shrink)

Background Ensuring individual free and informed decision‐making for research participation is challenging. It is thought that preliminarily informing communities through ‘community sensitization’ procedures may improve individual decision‐making. This study set out to assess the relevance of community sensitization for individual decision‐making in research participation in rural Gambia. Methods This anthropological mixed‐methods study triangulated qualitative methods and quantitative survey methods in the context of an observational study and a clinical trial on malaria carried out by the Medical Research Council Unit Gambia. (...) Results/discussion Although 38.7% of the respondents were present during sensitization sessions, 91.1% of the respondents were inclined to participate in the trial when surveyed after the sensitization and prior to the informed consent process. This difference can be explained by the informal transmission of information within the community after the community sensitization, expectations such as the benefits of participation based on previous research experiences, and the positive reputation of the research institute. Commonly mentioned barriers to participation were blood sampling and the potential disapproval of the household head. Conclusion Community sensitization is effective in providing first‐hand, reliable information to communities as the information is cascaded to those who could not attend the sessions. However, further research is needed to assess how the informal spread of information further shapes people's expectations, how the process engages with existing social relations and hierarchies (e.g. local political power structures; permissions of heads of households) and how this influences or changes individual consent. (shrink)

Background Levels of care deemed as inappropriate generate moral distress among nurses and other intensive care professionals. Inappropriate levels of care and related moral distress are frequently broached as individual and psychological phenomena, reduced to how individuals feel and think about specific cases. However, this tends to obscure the complex context in which these situations occur, and on which healthcare professionals can act. There is thus a need for a more contextual and team-level lens on inappropriate levels of care. Research (...) objective This study aims to explore and understand the issue of inappropriate levels of care in an intensive care unit (ICU) through a contextual and team-level lens. Research design Semi-structured interviews were conducted with nurses, respiratory therapists, and intensivists. Thematic analysis focused on understanding the causes and consequences of inappropriate levels of care, as well as potential avenues for improvement. This study is part of a 5-phase participatory living lab project on inappropriate levels of care conducted in the ICU of a Montreal (Quebec, Canada) hospital. This paper relates the initial phases of the project, focusing on understanding the issue, with reported events spanning from June 2022 to May 2023. Ethical considerations Ethics approval was sought and granted by the Research Ethics Board of the CIUSSS de l’Est-de-l’Île-de-Montréal. Findings/Discussion Five broad themes intrinsically related to the phenomenon of inappropriate levels of care were explored with and by participants: (1) the process of determining levels of care, (2) the distinction between appropriate and inappropriate levels of care, (3) causes of inappropriate levels of care, (4) consequences of inappropriate levels of care and (5) potential avenues for improvement. Conclusion This research provides a comprehensive understanding of inappropriate levels of care in the ICU and emphasizes the relevance of team-level explorations of complex ethical issues. (shrink)

Internationally, primary health care has in recent years gained a more central position in political priorities to ensure sustainable health care for the population. Thus, more people receive health care locally and in their own homes, where home‐care nursing plays a large role. In this article, we investigate how home‐care nursing is articulated and made visible in contemporary Norwegian policy documents. The study is a Fairclough‐inspired critical discourse analysis seeking to uncover the position of nursing in the prevailing political ideologies (...) on current primary health care. In the documents, we identified several complementary and conflicting understandings about home‐care nursing. Home‐care nursing is presented as a basic part of a municipality's health services, but at the same time, its content and contribution are unclear and almost invisible. We argue that the absence of nursing leads to significant perspectives being left out and tie this to the fact that some patient groups and tasks seem to be disadvantaged. The political placement of home‐care nursing in the health‐care landscape is thus not just about nursing as a professional practice but also concerns fundamental care values in our society in relation to disadvantaged groups and work tasks. (shrink)

Background/ObjectiveSeveral studies have examined the impact of Parkinson’s disease on the quality of couples’ relationships. To date, few studies have explored how couples experience their relationship dynamic by taking into account the disease stage. The objectives of this study were to understand the experience of each partner and to study the mechanisms that underlie their couple organization in the advanced stage of PD.MethodsSemistructured individual interviews conducted with fifteen patients and their partners were the subject of a dyadic interpretative phenomenological analysis.ResultsThree (...) themes were identified from the analysis: the first, “A Closeness That Separates,” allows the identification of different patterns of interactions that lead to emotional distancing between the partners; the second, “The Adversity Is Not Unbearable, But Going It Alone Would Be,” emphasizes the importance of how the assisting partner provides support; and the third, “Be Prepared for Anything and Facing an Uncertain Future,” reveals the extent and modes of the dyadic regulation of the emotions linked to what the future may hold.ConclusionPsychological support is important to help couples express both their feelings and their respective needs in the evolving context of PD. (shrink)

This article examines the human placenta not only as a scientific, medical and biological entity but as a consumer bio-product. In the emergent placenta economy, the human placenta is exchanged and gains potentiality as food, medicine and cosmetics. Drawing on empirical research from the United States, the United Kingdom, Denmark and Japan, the authors use feminist cultural analysis and consumer theories to discuss how the placenta is exchanged and gains commodity status as a medical supplement, smoothie, pill and anti-ageing lotion. (...) Placenta preparers and new mothers cite medical properties and spirituality as reasons for eating or encapsulating the placenta, reinstating ideas of the liberated good mother. Meanwhile, the cosmetics industry situates the placenta as an extract and hence a commodity, re-naturalizing it as an anti-ageing, rejuvenating and whitening bio-product. The authors conclude that, in the emergent bio-economy, the dichotomy between the inner and the outer body is deconstructed, while the placenta gains clinical and industrial as well as affective value. (shrink)

On the observational equivalence of continuous-time deterministic and indeterministic descriptions Content Type Journal Article Pages 193-225 DOI 10.1007/s13194-010-0011-5 Authors Charlotte Werndl, Department of Philosophy, Logic and Scientific Method, London School of Economics, Houghton Street, London, WC2A 2AE UK Journal European Journal for Philosophy of Science Online ISSN 1879-4920 Print ISSN 1879-4912 Journal Volume Volume 1 Journal Issue Volume 1, Number 2.

The Metaphysics of Gender is a book about gender essentialism: what it is and why it might be true.

Problematic substance use (PSU) among nurses has wide‐ranging adverse implications. A critical integrative literature review was conducted with an emphasis on building knowledge regarding the influence of structural factors within nurses' professional environments on nurses with PSU. Five thematic categories emerged: (i) access, (ii) stress, and (iii) attitudes as contributory factors, (iv) treatment policies for nurses with PSU, and (v) the culture of the nursing profession. Conclusions were that an overemphasis on individual culpability and failing predominates in the literature and (...) that crucial knowledge gaps exist regarding the influence of structural factors on driving and shaping nurses' substance use. (shrink)

Charlotte Sabourin | : Cet article vise à souligner l’importance du rôle joué par la conception kantienne des Lumières dans la Critique de la raison pure. On verra en effet que la connaissance de soi au coeur du projet critique gagne à être comprise en relation avec l’idée de penser par soi-même. Cette connaissance de soi dévoile cependant certaines erreurs tenaces commises par la raison, qui doivent précisément être rectifiées sous peine de compromettre la liberté de penser. La conception (...) kantienne des Lumières nous permettra ainsi de faire sens de la nature réflexive de l’entreprise critique. | : The aim of this paper is to show that the Kantian conception of enlightenment plays an important role in the Critique of Pure Reason. I will show that the self-knowledge central to Kant’s critical philosophy can be better understood by considering it in relation with the idea of thinking for oneself. Moreover, this self-knowledge reveals some deep-rooted errors made by pure reason that must be rectified in order not to compromise freedom of thought. I will thus use Kant’s conception of enlightenment to make sense of the reflexive nature of the critical project. (shrink)

This study explored the perceptions of ethics among long-term care employees (N275) in order to test two hypotheses. A cohort cross-sectional survey examined employees’ perceptions of an ethics environment, racial-ethnic, and position disparities (HO1; ANOVA), and, secondarily, ethics in relationship to select, research-grounded work features measured as manage disagreements, effectiveness, work satisfaction, and opinions of care, the latter including intention to remain (HO2; Pearson Correlations). Established questionnaires with robust psychometrics were employed. Response rate was 51%. Non-significant differences between sample and (...) population on key variables supported extrapolation of results. Statistically significant differences between racial–ethnic (p < 0.03; F 2.42) and work positions (p <0.0001; F 6.24) were revealed on ethics (3.16; HO1). Statistically significant relationships (p <0.0001; r = 0.26–0.68; HO2) between ethics and employees’ work features also were found, confirming both hypotheses. Perceptions of ethics based on racial-ethnic and position disparities, as well as the robust links with employee work features, offered potential avenues for decreasing disparities at work and improving the quality of long-term care. Noted further on ethics item scoring were relatively low scores indicating less involvement in, and access to, ethics discussions and decisions. In contrast, the literature review substantiated the importance of empowerment and retention, which were enhanced by employee involvement in work, notably, discussions and decisions. Thus, implications of ethics committees in long-term care sites as ways to potentially enhance employees’ work and quality of care, especially work satisfaction and retention, were explored; relevant concerns raised by the Covid pandemic were, briefly, discussed. (shrink)

Charlotte Sabourin | : Cet article se penche sur la contribution de Gabrielle Suchon à la célèbre « querelle des femmes ». J’y démontre que, quoique Suchon défende l’égalité des deux sexes en ce qui a trait à leurs capacités à la liberté, à la science et à l’autorité, elle vise ultimement à montrer que les femmes peuvent se rendre supérieures aux hommes. Je montrerai que son projet d’élévation des femmes ne peut être accompli qu’en soustrayant les femmes à (...) l’influence des hommes, les relations entre les deux sexes étant foncièrement préjudiciables aux premières. | : This paper examines Gabrielle Suchon’s contribution to the famous “querelle des femmes”. I argue that although Suchon is a proponent of the equality of the sexes with respect to their capacities for freedom, science and authority, she ultimately suggests that there is a way in which women can make themselves superior to men. I will show that her project for the elevation of women can be accomplished only by isolating women from men, given that the relationships between the sexes will always be detrimental to women. (shrink)

We are all immersed in a sea of social norms, but they are sometimes tricky to observe with any clarity. They are often invisible to us and emerge only when they are not observed. Social norms are important to understand because they are both limiting of our freedom, such as gendered and racialized norms, and at the same time the very conditions of our agency. Social Goodness presents an original, externalist answer to the question of the source or origin of (...) social role normativity. Rather than grounding social normativity in the attitudes of persons, the book argues for an externalism that roots social role normativity in the social world itself: in its positions, institutions, and larger architecture. The core insight of externalism is that the function or structural feature of an enterprise or activity can bring with it normative demands quite independently of the attitudes of those who engage with it. According to the artisanal model, just as a carpenter, ceramicist, or chef is responsive to and evaluable under a set of artisanal norms or techniques, so too is a mother and or an academic or a President. The source of normativity is this technique or expertise, independent of the preferences, endorsements, or recognitive attitudes of individuals. The artisanal model for social role normativity has resources to explain both the "stickiness" or persistence of social norms and our ability to criticize existing norms and to engage in normative self-creation--to create new normative selves. The artisanal model also has resources to capture and express the social situatedness, locality, and materiality of social roles. The relational ontology of social roles, implicit in the artisanal model, provides a useful frame to consider both hierarchical and oppressive social relations. (shrink)

According to the Spatial Quantity Association of Response Codes (SQUARC), people hold a mental association between horizontal position and quantity (lower quantities left, higher quantities right). While a large body of research has explored this effect for response speed and judgment accuracy, the affective downstream consequences of the SQUARC remain unexplored. Aiming to address this gap, the present two experiments (pre-registered, total N = 521) investigated whether stimulus arrangements that are compatible with the SQUARC for luminance are affectively preferred to (...) stimulus arrangements that are incompatible. SQUARC-compatible square arrangements (dark-left, bright-right) were preferred over SQUARC-incompatible square arrangements (dark-right, bright-left). The preference for SQUARC compatibility was not moderated by the horizontal orientation of the response scale. Our results confirm the direction of the spatial-luminance association and provide initial support that the cognitive processing of SQUARC compatibility is hedonically marked and appears sufficient to impact affective evaluations. (shrink)

Emotion differentiation has generally been viewed as a trait that is related to emotion regulation and well-being. There are theoretical considerations that state that the beneficial effect on well...

English summary: What was the intellectual dialogue between Aristotle and Plato that drove the formers concepts of ethics? This volume seeks to establish the background debate of Aristotle with his former teacher, one often depicted as adversarial but that created a dialectical character in which Aristotle built the cardinal notions of his ethical philosophy as responses to specific questions left open in Platos work. French description: Qu'Aristote ait lu Platon est de l'ordre de l'evidence. Cette evidence gagne neanmoins a etre (...) rappelee pour en degager toute la portee, plus particulierement dans le domaine de l'ethique ou le rapport d'Aristote a son maitre tend a etre reduit a la vision traditionnelle d'un disciple devenu un adversaire irreductible, et parfois injuste. Redonner voix au dialogue continu mais souterrain entre les ethiques des deux philosophes, en mettant au jour l'arriere-plan platonicien avec lequel Aristote est en debat, n'a pas pour seul but de reevaluer l'heritage platonicien du Stagirite. Une telle entreprise offre en meme temps une voie d'entree feconde dans l'elaboration de ses concepts ethiques, qu'il s'agisse du bonheur, du plaisir, de l'amitie ou de la sagesse pratique. En effet, faire l'hypothese qu'Aristote construit les notions cardinales de sa philosophie pratique comme des reponses precises a des questions non moins precises laissees ouvertes par les Dialogues permet d'en eclairer la genese et d'en degager les articulations constitutives. Bien loin d'etre un systeme statique de concepts, l'ethique aristotelicienne se trouve ainsi heriter du caractere dialectique plus volontiers attribue aux textes platoniciens qui enconstituent la toile de fond. La nouveaute comme la portee de l'intuition qui la guide, a savoir que le bien, pour les humains, reside dans l'action, s'apprecient mieux a l'aune de cette conversation continuee qu'elle entretient avec les questions et les prises de position de son predecesseur. (shrink)

ArgumentRecent studies in Sinology have shown that Qing dynasty editors acted as philologists. This paper argues that the identification of their philological methods and editorial choices suggests that their choices were not totally neutral and may have significantly shaped the way modern historians interpreted specific works edited by mathematicians of that dynasty. A case study of the re-edition in 1798 of a Song dynasty treatise, theYigu yanduan(1259), by a Qing dynasty mathematician will illustrate this point. At the end of the (...) eighteenth century, Li Rui (1773–1817) was asked to prepare an edition of the mathematical works written by Li Ye (1192–1279) for a private collection. Li Rui was a talented mathematician, but he was also a meticulous editor and trained philologist. He adopted his editorial model from the preparation of the imperial encyclopaedia, theSiku quanshu, but Li Rui also made some corrections to the text in an effort to restore an older version of Li Ye's treatises that had been lost. Convinced of the Chinese origin of algebra, Li Rui used philological techniques to recover the lost materials and to restore the roots of “Chinese mathematics.” TheYigu yanduancontains two algebraic procedures to set up quadratic equations, one from the procedure ofCelestial Source(tian yuan shu) and the other from theSection of Pieces[of Areas] (tiao duan). Curiously, the second procedure has not yet attracted the attention of scholars so far, although Li Rui's edition is the one typically used by twentieth-century historians of mathematics. Today, theCelestial Sourcecharacterizes “Chinese algebra.” However, the specific concerns of Li Rui about the procedure ofCelestial Source, combined with his editorial methods, contributed to this perspective. (shrink)

ABSTRACT When does a state of affairs constitute a harm to someone? Comparative accounts say that being worse off constitutes harm. The temporal version of the comparative account is seldom taken seriously, due to apparently fatal counterexamples. I defend the temporal version against these counterexamples, and show that it is in fact more plausible than the prominent counterfactual version of the account. Non-comparative accounts say that being badly off constitutes harm. However, neither the temporal comparative account nor the non-comparative account (...) can correctly classify all harms. I argue that we should combine them into a hybrid account of harm. The hybrid account is extensionally adequate and presents a unified view on the nature of harm. (shrink)

Patients in around 20 countries worldwide are now offered online access to at least some of their medical records. Access includes test results, medication lists, referral information, and/or the very words written by clinicians (so-called ‘open notes’). In this paper, I discuss the possibility of one unintended negative consequence of patient access to their clinical notes—the potential to increase ‘nocebo effects’. A growing body of research shows that nocebo effects arise by engaging perceptual and cognitive processes that influence negative expectancies, (...) and as a consequence, adverse health effects. Studies show that increased awareness about the side effects of medications, the framing of information and the socioemotional context of care can increase the risk of nocebo effects. Connecting research into the nocebo effect with open notes provides preliminary support for the hypothesis that patient access to clinical notes might be a forum for facilitating unwanted nocebo effects. Furthermore, current findings indicate that we might expect to see systematic differences in how nocebo effects are experienced among different patient populations. The ethical implications of the tension between transparency and the potential for harm are discussed, with an emphasis on what open notes might mean for justice and equity in clinical care for a range of already marginalised patient populations. I argue that to resolve these challenges does not thereby justify ‘closed notes’, and conclude with suggestions for how health systems and clinicians might adapt to this innovation to reduce the risk of potential nocebo effects arising via this novel route. (shrink)

« If there was one development we did not predict it was that, as well as getting larger, corpora would also get smaller! » McEnery et Wilson (2001 : 191) Doit-on qualifier de « petit corpus » tout corpus qui n’est pas grand? Et d’ailleurs, pourquoi faudrait-il se poser la question? Celle-ci peut paraître triviale mais elle signale un moment particulier des sciences du langage. L’informatique a permis l’établissement de grands corpus et le traitement d’impressionnantes quantités de données...

Cognitive‐enhancing drugs are prescribed to patients with psychiatric disorders, such as attention deficit hyperactivity disorder (ADHD) and Alzheimer's disease, to treat cognitive deficits. This chapter discusses the use of pharmacological agents to improve the cognition of both those with cognitive impairments and of the general population, as well as some of the benefits, risks, and ethical issues associated with the use of cognitive‐enhancing drugs. The chapter also talks about a survey run by the journal Nature, which was prompted by a (...) commentary by the authors of this chapter, that asked readers for their views on the issues surrounding cognitive enhancement. It can be seen that the ethical issues surrounding the use of cognitive‐enhancing drugs are complex and require discussion among different groups. With the development of new drugs and methods of enhancing cognition, such as brain stimulation, the need for further research and discussion is likely to become more pressing. (shrink)

In this article, we present a newly developed undergraduate module that is taught in the Humanities Department of the University of Roehampton. Campus and university themselves are the topics of th...

Background When anti-cancer treatments have been given market authorization, but are not (yet) reimbursed within a healthcare system, physicians are confronted with ethical dilemmas. Arranging access through other channels, e.g., hospital budgets or out-of-pocket payments by patients, may benefit patients, but leads to unequal access. Until now, little is known about the perspectives of physicians on access to non-reimbursed treatments. This interview study maps the experiences and moral views of Dutch oncologists and hematologists.Methods A diverse sample of oncologists and hematologists (...) (n = 22) were interviewed. Interviews were analyzed thematically using Nvivo 12 qualitative data software.Results This study reveals stark differences between physicians’ experiences and moral views on access to anti-cancer treatments that are not (yet) reimbursed: some physicians try to arrange other ways of access and some physicians do not. Some physicians inform patients about anti-cancer treatments that are not yet reimbursed, while others wait for reimbursement. Some physicians have principled moral objections to out-of-pocket payment, while others do not.Conclusion Oncologists and hematologists in the Netherlands differ greatly in their perspectives on access to expensive anti-cancer treatments that are not (yet) reimbursed. As a result, they may act differently when confronted with dilemmas in the consultation room. Physicians working in different healthcare systems may face similar dilemmas. (shrink)

In many countries, including patients are legally entitled to request copies of their clinical notes. However, this process remains time-consuming and burdensome, and it remains unclear how much of the medical record must be made available. Online access to notes offers a way to overcome these challenges and in around 10 countries worldwide, via secure web-based portals, many patients are now able to read at least some of the narrative reports written by clinicians (‘open notes’). However, even in countries that (...) have implemented the practice many clinicians have resisted the idea remaining doubtful of the value of opening notes, and anticipating patients will be confused or anxious by what they read. Against this scepticism, a growing body of qualitative and quantitative research reveals that patients derive multiple benefits from reading their notes. We address the contrasting perceptions of this practice innovation, and claim that the divergent views of patients and clinicians can be explained as a case of epistemic injustice. Using a range of evidence, we argue that patients are vulnerable to (oftentimes, non-intentional) epistemic injustice. Nonetheless, we conclude that the marginalisation of patients’ access to their health information exemplifies a form of epistemic exclusion, one with practical and ethical consequences including for patient safety. (shrink)

Aristotle's defense of Dunamis -- Power and potentiality -- Rational and nonrational powers -- The priority of actuality -- Ontological hierarchy, normativity, and gender.

The central question of this paper is: are deterministic and indeterministic descriptions observationally equivalent in the sense that they give the same predictions? I tackle this question for measure-theoretic deterministic systems and stochastic processes, both of which are ubiquitous in science. I first show that for many measure-theoretic deterministic systems there is a stochastic process which is observationally equivalent to the deterministic system. Conversely, I show that for all stochastic processes there is a measure-theoretic deterministic system which is observationally equivalent (...) to the stochastic process. Still, one might guess that the measure-theoretic deterministic systems which are observationally equivalent to stochastic processes used in science do not include any deterministic systems used in science. I argue that this is not so because deterministic systems used in science even give rise to Bernoulli processes. Despite this, one might guess that measure-theoretic deterministic systems used in science cannot give the same predictions at every observation level as stochastic processes used in science. By proving results in ergodic theory, I show that also this guess is misguided: there are several deterministic systems used in science which give the same predictions at every observation level as Markov processes. All these results show that measure-theoretic deterministic systems and stochastic processes are observationally equivalent more often than one might perhaps expect. Furthermore, I criticise the claims of the previous philosophy papers Suppes (1993, 1999), Suppes and de Barros (1996) and Winnie (1998) on observational equivalence. (shrink)

The doctor-patient relationship is built on an implicit covenant of trust, yet it was not until the post-World War Two era that respect for patient autonomy emerged as an article of mainstream medical ethics. Unlike their medical forebears, physicians today are expected to furnish patients with adequate information about diagnoses, prognoses and treatments. Against these dicta there has been ongoing debate over whether placebos pose a threat to patient autonomy. A key premise underlying medical ethics discussion is the notion that (...) the placebo effect necessitates patient deception. Indeed, the American Medical Association guidelines imply that placebo treatment necessary entails a form of deception. As a consequence of this assumption, the fulcrum of debate on the use of placebo treatment has hinged on whether that deception is ever justified. Recently performed experiments with open-label transparently prescribed placebos have begun to challenge the notion that deception is necessary in eliciting the placebo effect and such effects necessarily involve a binary distinction between autonomy and beneficence. In this article we focus on the content of disclosures in distinctive open-label, transparently disclosed placebo studies and inquire whether they might be said to invoke deception in clinical contexts, and if so, whether the deception is unethical. We find that open placebos may be said to involve equivocation over how placebos work. However, drawing on surveys of patient attitudes we suggest that this equivocation appears to be acceptable to patients. We conclude that open placebos fulfil current American Medical Association guidelines for placebo use, and propose future research directions for harnessing the placebo effect ethically. (shrink)

This paper addresses the actual practice of justifying definitions in mathematics. First, I introduce the main account of this issue, namely Lakatos's proof-generated definitions. Based on a case study of definitions of randomness in ergodic theory, I identify three other common ways of justifying definitions: natural-world justification, condition justification, and redundancy justification. Also, I clarify the interrelationships between the different kinds of justification. Finally, I point out how Lakatos's ideas are limited: they fail to show how various kinds of justification (...) can be found and can be reasonable, and they fail to acknowledge the interplay among the different kinds of justification. (shrink)

Researchers have begun to use response times to emotion items as an indirect measure of emotional clarity. Our first aim was to scrutinise the properties of this RT measure in more detail than previously. To be able to provide recommendations as to whether emotional intensity – as a possible confound – should be controlled for, we investigated the specific form of the relation between emotional intensity and RTs to emotion items. In particular, we assumed an inverted U-shaped relation at the (...) item level. Moreover, we analysed the RT measure’s convergent validity with respect to individuals’ confidence in their emotion ratings. As a second aim, we compared the predictive validity of emotional clarity measures with respect to daily emotion regulation. The results of three experience sampling studies showed that the association between emotional intensity and RT followed an inverted U shape. RT was in part related to confidence. Emotional clarity measures were unrelated to reappraisal. There was some evidence that lower emotional clarity was related to a greater use of suppression. The findings highlight that emotional intensity and squared emotional intensity should be controlled for when using the RT measure of emotional clarity in future research. (shrink)

In the field of placebo studies residual disagreement about the terminology ‘placebo’ and ‘placebo effect’ still persists. We differentiate between the conceptualization of placebos in clinical trials; and placebo effects understood as a psychobiological phenomenon. With respect to the latter, we argue that a scientific ‘placebo paradigm’ has emerged, indicating that—at least among placebo scientists—there exists relatively stable consensus about how to conceive of placebo effects. We claim that existence of a placebo paradigm does not protect concepts from revision; nonetheless, (...) we argue that scientific progress is dependent on, and guided by relative conceptual stability. Therefore, to mount persuasive arguments for conceptual revision in respect of ‘placebo effects’ we argue, critics either need to defend the claim that a placebo paradigm is not underway, or that there are major scientific failings in respect of it. With these considerations in mind we examine three alternative proposals for conceptual reform: Grünbaum/Howick’s relativity models of placebo concepts; Moerman/Brody’s meaning response; and Nunn/Turner’s proposal for conceptual eliminativism. We derive two conclusions from this evaluation. First, we conclude that no convincing arguments have so far been presented for conceptual overhaul of ‘placebo effects.’ Notwithstanding this analysis, we conclude that refinement of this concept is likely. Second, we agree with Turner and Nunn that the term ‘placebo’ in the context of randomized controlled trials remains a source of confusion for many researchers, risking the design and scientific integrity of clinical findings. Therefore, in these contexts, replacing the term ‘placebo’ with ‘control’ is justified. (shrink)

This book uses the body to peel back the layers of time and taken-for-granted ideas about the two defining political forms of modernity, the state and the subject of rights. It traces, under the lens of the body, how the state and the subject mutually constituted each other since their original crafting in the seventeenth century. Considering multiple sites of theory and practice, Charlotte Epstein analyses the fundamental rights to security, liberty, and property respectively as the initial knots where (...) the state-subject relation was first sealed. (shrink)