This article reviews recent developments in experimental facial attractiveness research. It outlines the important social consequences of facial attractiveness in social life and briefly reviews the structural factors associated with attractiveness in both sexes taking a theoretical perspective largely influenced by evolutionary biology. The study discusses individual differences in preferences from this theoretical perspective. Attractiveness is also affected by aspects of the face that are manifestly not static. Facial motion and expression involve changing configurations of the face and the execution (...) of specific, discrete gestures that are likely to contribute to attractiveness and yet are largely neglected in the current literature. It shows how an evolutionary viewpoint is also useful when considering attractiveness judgments when expressive or dynamic cues are present in stimuli. (shrink)

This study attempts to refine and test a theory of social influences on ethical decisions of journalists. The theoretical model proposes that several social factors influence any given decision, and that a hierarchy of influences assigns relative value to each: individual, small group, organization, competition, occupation, extramedia, and law. Print and broadcast journalists reacted to 3 hypothetical scenarios that raised ethical problems. The journalists then rated the salience of various reasoning statements, each representing 1 of the 7 social influences. No (...) single source of ethical guidance appeared; in many cases different influences emerge as powerful under different circumstances. But of the 7 proposed influences, 5 showed consistent strength in predicting the decision the journalist makes. The individual influence was the weakest of the 7, despite its prominent strength in the literature. The organizational and small-group strength suggests company-level strategies for media policy-makers who wish to increase journalists'ethical awareness. Overall, the study seems to challenge a traditional assumption that in ethical dilemmas journalists are autonomous moral agents, acting on the basis of their own values alone. The data support the notion of a far more dynamic and complex pattern of social influences. (shrink)

How do journalists sort out the tangle of legal rights and ethical responsibilities in their everyday news work? A survey of 1,037 journalists and in-depth interviews with 22 others, found substantial evidence for 3 models of the relation of law and ethics: a Separate Realms model, a Correspondence model, and a new "Responsibility Model" in which the law is considered in problematic situations but only as one of several considerations in what is essentially an ethical decision. The findings have implications (...) for the maintenance of generous levels of First Amendment freedom news media currently enjoy. (shrink)

I propose to explain Kant’s novel claim, in the Critique of Pure Reason, that all judgments have a formal modality. I begin by distinguishing the modality of a judgment’s form from the modality of its content, and I suggest that the former is peculiar in merely affecting the subject’s understanding of his own act of judging. I then contrast the modal account of such an understanding (in terms of the possibility and actuality of a judgment) with the traditional, non-modal understanding (...) of it (in terms of the giving and withholding of assent). I conclude by suggesting that Kant prefers the former because he conceives of knowledge on Aristotle’s model: as a progress in the mind from capacity to act. (shrink)

Discovering Spinoza's early modern psychology some 35 years into his own clinical practice, Ian Miller now gives shape to this connection through a close reading of Spinoza's key philosophical ideas. With a rigorous and expansive analysis of Spinoza's Ethics in particular, Miller explores how Spinozan thought simultaneously empowered the original conceptual direction of psychoanalytic thinking, and anticipated the field's contemporary theoretical dimensions. Miller offers a detailed overview of the philosopher's psychoanalytic reception from the early work of German-language psychoanalytic thinkers, such (...) as Freud and Andreas Lou-Salome, forward into its Anglophone reception, influencing both mid-century humanistic American psychoanalysis as well as anticipating thinkers such as Bion and Winnicott. Covering key concepts in psychoanalytic theory and clinical practice, this book demonstrates how knowledge of Spinoza's philosophical work can help to both illuminate and improve modern psychoanalytic therapies. (shrink)

This chapter aims to contribute to the endeavour of investigating nonhuman animals as experiencing subjects in their own right with their own species-specific histories. Our focus is on the examination of pain experience in animals. We argue that there is need for more research in which pain experience in animals is accounted for in species-specific terms. Making use of empirical studies in the fields of neurobiology, evolutionary-developmental biology, comparative psychology, and cognitive ethology, we try to offer a phenomenological analysis of (...) indications and expressions of pain experience in animals. We attempt to show how different animals are capable of indicating and expressing specific and unique experiences of pain in terms of their particular species, evolution, and places of living in human and natural contexts. (shrink)

Do Morals Matter? is an accessible and informed guide to contemporary ethical issues that reflects upon the intersection of religion and morality. An informal yet informed guide through the key ethical issues we are facing today, from moral decision making in business and medicine, to the uncertainty of war and terrorism, and the condition of our environment. Reflects on religion’s intersection with morality, exploring the challenge of pluralism in major world religions, and the question of Humanism and God’s role in (...) ethics. Considers the forecast of future situations that will be affected by today’s ethical decisions. Questions what accounts for the variances in ethical beliefs in different cultures, and how we properly reassess our conceptions of ethical standards as new issues arise. Written by the internationally regarded Ian Markham, Dean of Hartford Seminary and author of numerous books on world religions and ethics. (shrink)

Too many parts of the world testify to the difficulties religions have in tolerating each other. It is often concluded that the only way tolerance and plurality can be protected is to keep religion out of the public sphere. Ian Markham challenges this secularist argument. In the first half of the book, he advances a careful critique of European culture which exposes the problem of plurality. His analysis of the Christendom Group is contrasted with the outlook found in the USA, (...) where a religiously informed culture may be seen to be tolerant. In the second half of the book, the author argues that plurality is better safeguarded by a theistic, rather than a secularist, foundation. He submits that too often secularists use relativist arguments, while theists want to appeal to the complexity of God's world. He concludes that in our post-modern world the religious affirmation of diversity offers genuine political possibilities for cultural enrichment. (shrink)

In five works spanning a decade, Philip E. Tetlock's interest in counterfactuals has changed. He began with an optimistic desire to make social science more rigorous by identifying best practices in the absence of non-imagined controls for experimentation. Soon, however, he adopted a more pessimistic analysis of the cognitive and psychological barriers facing experts. This shift was brought on by an awareness that experts are not rational Bayesians who continually update their theories to keep up with new information; but instead (...) are affected by political, cognitive, and psychological heuristics, including hindsight bias, cognitive conservatism, and the fundamental attribution error. But techniques of computational simulation-involving the rigorous production of large numbers of counterfactual worlds-make it possible to mitigate both problems that Tetlock identifies: that history, produced only once, is a lousy teacher; and that humans, with their collection of non-Bayesian heuristics, are lousy pupils. Tetlock was wrong to reject this approach as theoretically promising but rhetorically and practically impractical. (shrink)

This article re-evaluates the significance attributed to Hecataeus¿ encounter with the Theban priests described by Herodotus (2.143) by setting it against the evidence of Late Period Egyptian representations of the past. In the first part a critique is offered of various approaches Classicists have taken to this episode and its impact on Greek historiography. Classicists have generally imagined this as an encounter in which the young, dynamic and creative Greeks construct an image of the static, ossified and incredibly old culture (...) of the Egyptians, a move which reveals deeper assumptions in the scholarly discourse on Greeks and ¿other¿ cultures in the Mediterranean world. But the civilization that Herodotus confronted in his long excursus on Egypt was not an abstract, eternal Egypt. Rather, it was the Egypt of his own day, at a specific historical moment ¿ a culture with a particular understanding of its own long history. The second part presents evidence of lengthy Late Period priestly genealogies, and more general archaizing tendencies. Remarkable examples survive of the sort of visual genealogy which would have impressed upon the travelling Greek historians the long continuum of the Egyptian past. These include statues with genealogical inscriptions and relief sculptures representing generations of priests succeeding to their fathers¿ office. These priestly evocations of a present firmly anchored in the Egyptian past are part of a wider pattern of cultivating links with the historical past in the Late Period of Egyptian history. Thus, it is not simply the marvel of a massive expanse of time which Herodotus encountered in Egypt, but a mediated cultural awareness of that time. The third part of the essay argues that Herodotus used this long human past presented by the Egyptian priests in order to criticize genealogical and mythical representations of the past and develop the notion of an historical past. On the basis of this example, the article concludes by urging a reconsideration of the scholarly paradigm for imagining the encounter between Greeks and ¿others¿ in ethnographic discourse in order to recognize the agency of the Egyptian priests, and other non-Greek ¿informants¿. (shrink)

Thinking about ethics -- Philosophical ethics -- Why not do wrong? -- Is the ethical a human construct or a factual realm? -- Do you just do what is right or do you try to predict the outcomes? -- Natural law and virtue ethics -- Ethics and the bible -- Learning from the wisdom of the world -- Humanism : do we need god to realize that people just matter? -- Ethical dilemmas -- Dilemmas in bed -- Dilemmas in business (...) -- Dilemmas in medicine -- Dilemmas involving violence and power -- Dilemmas in government and leadership -- Dilemmas and the future : the environment, animals, and plants -- Dilemmas in the cyber world -- Making a decision -- Becoming a morally serious person -- Taking an ethical position. (shrink)

Yet many in the USA and Europe are not familiar with his important work; this book seeks to rectify that gap.In Globalization, Ethics and Islam, Jewish, ...

The value scenario is a useful tool in the sheaf of methods within value sensitive design. When envisioning new technology, this tool supports the designer in speculatively considering relevant stakeholders, values expressed or rebuffed by an artifact’s design, and tensions that may exist between those values. This paper explores how science fiction stories can serve as value scenarios to supplement traditional historical methods, especially when informants are no longer accessible.

Health services internationally struggle to ensure health care is “person-centered” (or similar). In part, this is because there are many interpretations of “person-centered care” (and near synonyms), some of which seem unrealistic for some patients or situations and obscure the intrinsic value of patients’ experiences of health care delivery. The general concern behind calls for person-centered care is an ethical one: Patients should be “treated as persons.” We made novel use of insights from the capabilities approach to characterize person-centered care (...) as care that recognizes and cultivates the capabilities associated with the concept of persons. This characterization unifies key features from previous characterisations and can render person-centered care applicable to diverse patients and situations. By tying person-centered care to intrinsically valuable capability outcomes, it incorporates a requirement for responsiveness to individuals and explains why person-centered care is required independently of any contribution it may make to health gain. (shrink)

Everyday Writing in the Graeco-Roman East. By Roger S. Bagnall. Sather Classical Lectures, vol. 69. Berkeley and Los Angeles: University of California Press, 2011. Pp. xiv + 179, illus. $49.95.

In a companion review1 we discussed the data supporting the conclusion that at least two subtypes of spectrin exist in mammalian brain. One form is found in the cell bodies, dendrites, and post‐synaptic terminals of neurons (brain spectrin(240/235E)) and the other subtype is located in the axons and presynaptic terminals (brain spectrin(240/235)). Our recent understanding of brain spectrin subtype localization suggests a possible explanation for a conundrum concerning brain 4.1 localization. Amelin, an immunoreactive analogue of red blood cell (rbc) cytoskeletal (...) protein 4.1, is localized in neuronal cell bodies and dendrites when brain sections are stained with antibody against rbc protein 4.1. However, it has recently been suggested that synapsin I, a neuron‐specific phosphoprotein associated with the cytoplasmic surface of small synaptic vesicles, is related to erythrocyte 4.1. In this review we hypothesize that there are at least two forms of brain 4.1: a cell body/dendritic form (amelin) which is detected with rbc protein 4.1 antibody, and a unique form found exclusively in the presynaptic terminal (synapsin I). The binding of synapsin I to brain spectrin(240/235), and its ability to stimulate the spectrin/F‐actin interaction in a phosphorylation‐dependent manner suggests a model for the regulation of synaptic transmission mediated by the neuronal cytoskeleton. (shrink)

Here the distinguished philosopher Ian Hacking uses the MPD epidemic and its links with the contemporary concept of child abuse to scrutinize today's moral...

One of Ian Hacking's earliest publications, this book showcases his early ideas on the central concepts and questions surrounding statistical reasoning. He explores the basic principles of statistical reasoning and tests them, both at a philosophical level and in terms of their practical consequences for statisticians. Presented in a fresh twenty-first-century series livery, and including a specially commissioned preface written by Jan-Willem Romeijn, illuminating its enduring importance and relevance to philosophical enquiry, Hacking's influential and original work has been revived for (...) a new generation of readers. (shrink)

Recent advances in virtual technologies have allowed the investigation of simulated moral actions in aversive moral dilemmas. Previous studies have employed diverse populations in order to explore these actions, with little research considering the significance of occupation on moral decision-making. For the first time, in this study we have investigated simulated moral actions in Virtual Reality made by professionally trained paramedics and fire service incident commanders who are frequently faced with and must respond to moral dilemmas. We found that specially (...) trained individuals showed distinct empathic and related personality trait scores and that these declined with years of experience working in the profession. Supporting the theory that these professionals develop resilience in moral conflict, reduced emotional arousal was observed during virtual simulations of a distressing dilemma. Furthermore, trained professionals demonstrated less regret following the execution of a moral action in virtual reality when compared to untrained control populations. We showed that, contrary to previous research, trained individuals made the same moral judgments and moral actions as untrained individuals, though showing less arousal and regret. In the face of increasing concerns regarding empathy decline in healthcare professionals, we suggest that the nature of this decline is complex and likely reflects the development of a necessary emotional resilience to distressing events. (shrink)

This article analyses the phenomenon of epistemic injustice within contemporary healthcare. We begin by detailing the persistent complaints patients make about their testimonial frustration and hermeneutical marginalization, and the negative impact this has on their care. We offer an epistemic analysis of this problem using Miranda Fricker's account of epistemic injustice. We detail two types of epistemic injustice, testimonial and hermeneutical, and identify the negative stereotypes and structural features of modern healthcare practices that generate them. We claim that these stereotypes (...) and structural features render ill persons especially vulnerable to these two types of epistemic injustice. We end by proposing five avenues for further work on epistemic injustice in healthcare. (shrink)

Democracy and justice are often mutually antagonistic ideas, but in this innovative book Ian Shapiro shows how and why they should be pursued together. Justice must be sought democratically if it is to garner legitimacy in the modern world, he claims, and democracy must be justice-promoting if it is to sustain allegiance over time. _Democratic Justice_ meets these criteria, offering an attractive vision of a practical path to a better future. Wherever power is exercised in human affairs, Shapiro argues, the (...) lack of democracy will be experienced as injustice. The challenge is to democratize social relations so as to diminish injustice, but to do this in ways that are compatible with people’s values and goals. Shapiro shows how this can be done in different phases of the human life cycle, from childhood through the adult worlds of work and domestic life, retirement, old age, and approaching death. He spells out the implications for pressing debates about authority over children, the law of marriage and divorce, population control, governing the firm, basic income guarantees, health insurance, retirement policies, and decisions made by and for the infirm elderly. This refreshing encounter between political philosophy and practical politics will interest all those who aspire to bequeath a more just world to our children than the one we have inherited. (shrink)

The _Mozi_ is a key philosophical work written by a major social and political thinker of the fifth century B.C.E. It is one of the few texts to survive the Warring States period and is crucial to understanding the origins of Chinese philosophy and two other foundational works, the _Mengzi_ and the _Xunzi_. Ian Johnston provides an English translation of the entire _Mozi_, as well as the first bilingual edition in any European language to be published in the West. His (...) careful translation reasserts the significance of the text's central doctrines, and his annotations and contextual explanations add vivid historical and interpretive dimensions. Part 1 of the _Mozi_ is called the "Epitomes" and contains seven short essays on the elements of Mohist doctrine. Part 2, the "Core Doctrines," establishes the ten central tenets of Mo Zi's ethical, social, and political philosophy, while articulating his opposition to Confucianism. Part 3, the "Canons and Explanations," comprises observations on logic, language, disputation, ethics, science, and other matters, written particularly in defense of Mohism. Part 4, the "Dialogues," presents lively conversations between Master Mo and various disciples, philosophical opponents, and potential patrons. Part 5, the "Defense Chapters," details the principles and practices of defensive warfare, a subject on which Master Mo was an acknowledged authority. Now available to English-speaking readers of all backgrounds, the Mozi is a rich and varied text, and this bilingual edition provides an excellent tool for learning classical Chinese. (shrink)

This is an introductory 2001 textbook on probability and induction written by one of the world's foremost philosophers of science. The book has been designed to offer maximal accessibility to the widest range of students and assumes no formal training in elementary symbolic logic. It offers a comprehensive course covering all basic definitions of induction and probability, and considers such topics as decision theory, Bayesianism, frequency ideas, and the philosophical problem of induction. The key features of this book are a (...) lively and vigorous prose style; lucid and systematic organization and presentation of ideas; many practical applications; a rich supply of exercises drawing on examples from such fields as psychology, ecology, economics, bioethics, engineering, and political science; numerous brief historical accounts of how fundamental ideas of probability and induction developed; and a full bibliography of further reading. (shrink)

What is the purpose of perception? And how might the answer to this question help distinguish perception from other mental processes? Block’s landmark book, The.

The conviction that Gilles Deleuze is doing something radical in his work has been accompanied by a corresponding anxiety as to how to read it. In this rigorous and lucid work, Ian Buchanan takes up the challenge by answering the following questions: How should we read Deleuze? How should we read _with_ Deleuze? To show us how Deleuze’s philosophy works, Buchanan begins with Melville’s notion that “a great book is always the inverse of another book that could only be written (...) in the soul, with silence and blood.” Buchanan demonstrates that the figure of two books—one written in ink and the other written in blood—lies at the center of Deleuze’s hermeneutics and that a special relation must be established in order to read the second book from the first. This relation is Deleuzism. By explicating elemental concepts in Deleuze—desire, flow, the nomad—Buchanan finds that, despite Deleuze’s self-declared moratorium on dialectics, he was in several important respects a dialectician. In essays that address the “prehistory” of Deleuze’s philosophy, his methodology, and the utopic dimensions of his thought, Buchanan extracts an apparatus of social critique that arises from the philosopher’s utopian impulse. _Deleuzism_ is a work that will engage all those with an interest in the twentieth-century’s most original philosopher. (shrink)

Ill persons suffer from a variety of epistemically-inflected harms and wrongs. Many of these are interpretable as specific forms of what we dub pathocentric epistemic injustices, these being ones that target and track ill persons. We sketch the general forms of pathocentric testimonial and hermeneutical injustice, each of which are pervasive within the experiences of ill persons during their encounters in healthcare contexts and the social world. What’s epistemically unjust might not be only agents, communities and institutions, but the theoretical (...) conceptions of health that structure our responses to illness. Thus, we suggest that although such pathocentric epistemic injustices have a variety of interpersonal and structural causes, they are also sustained by a deeper naturalistic conception of the nature of illness. (shrink)

Philosophers have lately seized upon Sperling's partial report technique and subsequent work on iconic memory in support of controversial claims about perceptual experience, in particular that phenomenology overflows cognitive access. Drawing on mounting evidence concerning postdictive perception, I offer an interpretation of Sperling's data in terms of cue-sensitive experience which fails to support any such claims. Arguments for overflow based on change-detection paradigms (e.g. Landman et al., 2003; Sligte et al., 2008) cannot be blocked in this way. However, such paradigms (...) are fundamentally different from Sperling's and, for rather different reasons, equally fail to establish controversial claims about perceptual experience. (shrink)

Bringing together important writings not easily available elsewhere, this volume provides a convenient and stimulating overview of recent work in the philosophy of science. The contributors include Paul Feyerabend, Ian Hacking, T.S. Kuhn, Imre Lakatos, Laurens Laudan, Karl Popper, Hilary Putnam, and Dudley Shapere. In addition, Hacking provides an introductory essay and a selective bibliography.

Kant conceived of 'critique' as a kind of winnowing exercise, with the aim of separating the wheat of good metaphysics from the chaff of bad. He used a less familiar metaphor to make this point, namely, that of 'the fiery test of critique'-not a medieval ordeal of trial by fire, but rather a metallurgical assay, or cupellation, a procedure in which ore samples are tested for their precious-metal content. When seen in this light, critique has a positive, investigatory side: it (...) seeks not merely to eliminate bad, 'dogmatic' metaphysics but also to uncover what of philosophical value might be contained in traditional speculative metaphysics. In this comprehensive study of the Transcendental Dialectic in Kant's Critique of Pure Reason, Proops argues that Kant uncovered two nuggets of value: the indirect proof of Transcendental Idealism afforded by the resolution of the Antinomies, and a defence of theoretically grounded 'doctrinal beliefs' in a wise and great originator, on the one hand, and in an afterlife, on the other. This examination of critique engages with Kant's views on a number of central problems in philosophy and meta-philosophy: the explanation of the enduring human impulse towards metaphysics, the correct philosophical method, the limits of self-knowledge, the possibility of human freedom, the resolution of metaphysical paradox, the justification of faith, the nature of scepticism, and the role of 'as if' reasoning in natural science. (shrink)

Experimental philosophy of religion is the project of taking the tools and resources of the human sciences—especially psychology and cognitive science—and bringing them to bear on issues within philosophy of religion toward explicit philosophical ends. This paper introduces readers to experimental philosophy of religion. §1 explores the contours of experimental philosophy of religion by contrasting it with a few related fields: the psychology of religion and cognitive science of religion, on the one hand, and natural theology, on the other. §2 (...) offers a brief history of experimental philosophy of religion. The goal in this section is to highlight the ancient pedigree of this emerging area of research; as the contemporary experimental philosophy of religion literature expands and proliferates, it’s important to remember that this field has deep historical roots. Then, §3 focuses on the following questions: Why should we care about experimental philosophy of religion? And why is it needed? (shrink)

_Philosophy and Animal Life_ offers a new way of thinking about animal rights, our obligation to animals, and the nature of philosophy itself. Cora Diamond begins with "The Difficulty of Reality and the Difficulty of Philosophy," in which she accuses analytical philosophy of evading, or deflecting, the responsibility of human beings toward nonhuman animals. Diamond then explores the animal question as it is bound up with the more general problem of philosophical skepticism. Focusing specifically on J. M. Coetzee's _The Lives (...) of Animals_, she considers the failure of language to capture the vulnerability of humans and animals. Stanley Cavell responds to Diamond's argument with his own close reading of Coetzee's work, connecting the human-animal relation to further themes of morality and philosophy. John McDowell follows with a critique of both Diamond and Cavell, and Ian Hacking explains why Cora Diamond's essay is so deeply perturbing and, paradoxically for a philosopher, he favors poetry over philosophy as a way of overcoming some of her difficulties. Cary Wolfe's introduction situates these arguments within the broader context of contemporary continental philosophy and theory, particularly Jacques Derrida's work on deconstruction and the question of the animal. _Philosophy and Animal Life_ is a crucial collection for those interested in animal rights, ethics, and the development of philosophical inquiry. It also offers a unique exploration of the role of ethics in Coetzee's fiction. (shrink)

How must experience of time be structured in time? In particular, does the following principle, which I will call inheritance, hold: for any temporal property apparently presented in perceptual experience, experience itself has that same temporal property. For instance, if I hear Paul McCartney singing ‘Hey Jude’, must my auditory experience of the ‘Hey’ itself precede my auditory experience of the ‘Jude’, or can the temporal order of these experiences come apart from the order the words are experienced as having? (...) A number of recent authors (Phillips Experience and Time, ‘The Temporal Structure of Experience’, Soteriou ‘Perceiving Events’, Hoerl ‘“A Succession of Feelings, in and of Itself, is Not a Feeling of Succession”’, Rashbrook) claim, to paraphrase Martin (399), that inheritance best characterises how our temporal experience seems to initial reflective intuition. For this reason, Phillips takes the principle to form part of our naïve view of temporal experience. An opposing group of theorists object that inheritance is subject to empirical counter-example. This article surveys such challenges. Section 2 considers Grush's case against inheritance based on postdiction. Section 3 examines Watzl's anti-inheritance argument based on silencing effects. Finally, Section 4 explores a number of alleged counter-examples proposed by Lee (‘Temporal Experience and the Temporal Structure of Experience’). Section 1 provides essential background to the debate. (shrink)

ABSTRACT I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments. INTRODUCTION In contrast to the classic model of randomized-control trials, often with a large number of (...) subjects enrolled, precision medicine attempts to optimize therapeutic outcomes by focusing on the individual.[i] A recent publication highlights the strengths and weakness of both traditional evidence-based medicine and precision medicine.[ii] Plus, it outlines a tension in the shift from evidence-based medicine’s inductive reasoning style (the collection of data to postulate general theories) to precision medicine’s abductive reasoning style (the generation of an idea from the limited data available).[iii] The paper’s main example is the application of precision medicine for the treatment of cancer.[iv] I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. As the name suggests, brain-computer interfaces are a significant advancement in neurotechnology that directly connects someone’s brain to external or implanted devices.[v] Among the various kinds of brain-computer interfaces, adaptive deep brain stimulation devices require numerous personalized adjustments to their settings during the implantation and computation stages in order to provide adequate relief to patients with treatment-resistant disorders. What makes these devices unique is how adaptive deep brain stimulation integrates a sensory component to initiate the stimulation. While not commonly at the level of sophistication as self-supervising or generative large language models,[vi] they currently allow for a semi-autonomous form of neuromodulation. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments.[vii] ANALYSIS I. The State of Precision Medicine in Oncology and the Epistemological Shift While a thorough overview of precision medicine for the treatment of cancer is beyond the scope of this article, its practice can be roughly summarized as identifying clinically significant characteristics a patient possesses (e.g., genetic traits) to land on a specialized treatment option that, theoretically, should benefit the patient the most.[viii] However, in such a practice of stratification patients fall into smaller and smaller populations and the quality of evidence that can be applied to anyone outside these decreases in turn.[ix] As inductive logic helps to articulate, the greater the number of patients that respond to a particular therapy the higher the probability of its efficacy. By straying from this logical framework, precision medicine opens the treatment of cancer to more uncertainty about the validity of these approaches to the resulting disease subcategories.[x] Thus, while contemporary medical practices explicitly describe some treatments as “personalized”, they ought not be viewed as inherently better founded than other therapies.[xi] A relevant contemporary case of precision medicine out of Norway focuses on the care of a patient with cancer between the ventricles of the heart and esophagus, which had failed to respond to the standard regimen of therapies over four years.[xii] In a last-ditch effort, the patient elected to pay out-of-pocket for an experimental immunotherapy (nivolumab) at a private hospital. He experienced marked improvements and a reduction in the size of the tumor. Understandably, the patient tried to pursue further rounds of nivolumab at a public hospital. However, the hospital initially declined to pay for it given the “lack of evidence from randomised clinical trials for this drug relating to this [patient’s] condition.”[xiii] In rebuttal to this claim, the patient countered that he was actually similar to a subpopulation of patients who responded in “open‐label, single arm, phase 2 studies on another immune therapy drug” (pembrolizumab).[xiv] Given this interpretation of the prior studies and the patient’s response, further rounds of nivolumab were approved. Had the patient not had improvements in the tumor’s size following a round of nivolumab, then pembrolizumab’s prior empirical evidence in isolation would have been insufficient, inductively speaking, to justify his continued use of nivolumab.[xv] The case demonstrates a shift in reasoning from the traditional induction to abduction. The phenomenon of ‘cancer improvement’ is considered causally linked to nivolumab and its underlying physiological mechanisms.[xvi] However, “the weakness of abductions is that there may always be some other better, unknown explanation for an effect. The patient may for example belong to a special subgroup that spontaneously improves, or the change may be a placebo effect. This does not mean, however, that abductive inferences cannot be strong or reasonable, in the sense that they can make a conclusion probable.”[xvii] To demonstrate the limitations of relying on the abductive standard in isolation, commentators have pointed out that side effects in precision medicine are hard to rule out as being related to the initial intervention itself unless trends from a group of patients are taken into consideration.[xviii] As artificial intelligence (AI) assists the development of precision medicine for oncology, this uncertainty ought to be taken into consideration. The implementation of AI has been crucial to the development of precision medicine by providing a way to combine large patient datasets or a single patient with a large number of unique variables with machine learning to recommend matches based on statistics and probability of success upon which practitioners can base medical recommendations.[xix] The AI is usually not establishing a causal relationship[xx] – it is predicting. So, as AI bleeds into medical devices, like brain-computer interfaces, the same cautions about using abductive reasoning alone should be carried over. II. Responsive Neurostimulation, AI, and Personalized Medicine Like precision medicine in cancer treatment, computer-brain interface technology similarly focuses on the individual patient through personalized settings. In order to properly expose the intersection of AI, precision medicine, abductive reasoning, and implantable neurotechnologies, the descriptions of adaptive deep brain stimulation systems need to deepen.[xxi] As a broad summary of adaptive deep brain stimulation, to provide a patient with the therapeutic stimulation, a neural signal, typically referred to as a local field potential,[xxii] must first be detected and then interpreted by the device. The main adaptive deep brain stimulation device with premarket approval, the NeuroPace Responsive Neurostimulation system, is used to treat epilepsy by detecting and storing “programmer-defined phenomena.”[xxiii] Providers can optimize the detection settings of the device to align with the patient’s unique electrographic seizures as well as personalize the reacting stimulation’s parameters.[xxiv] The provider adjusts the technology based on trial and error. One day machine learning algorithms will be able to regularly aid this process in myriad ways, such as by identifying the specific stimulation settings a patient may respond to ahead of time based on their electrophysiological signatures.[xxv] Either way, with AI or programmers, adaptive neurostimulation technologies are individualized and therefore operate in line with precision medicine rather than standard treatments based on large clinical trials. Contemporary neurostimulation devices are not usually sophisticated enough to be prominent in AI discussions where the topics of neural networks, deep learning, generative models, and self-attention dominate the conversation. However, implantable high-density electrocorticography arrays (a much more sensitive version than adaptive deep brain stimulation systems use) have been used in combination with neural networks to help patients with neurologic deficits from a prior stroke “speak” through a virtual avatar.[xxvi] In some experimental situations, algorithms are optimizing stimulation parameters with increasing levels of independence.[xxvii] An example of neurostimulation that is analogous to the use of nivolumab in Norway surrounds a patient in the United States who was experiencing both treatment-resistant OCD and temporal lobe epilepsy.[xxviii]Given the refractory nature of her epilepsy, implantation of an adaptive deep brain stimulation system was indicated. As a form of experimental therapy, her treatment-resistant OCD was also indicated for the off-label use of an adaptive deep brain stimulation set-up. Another deep brain stimulation lead, other than the one implanted for epilepsy, was placed in the patient’s right nucleus accumbens and ventral pallidum region given the correlation these nuclei had with OCD symptoms in prior research. Following this, the patient underwent “1) ambulatory, patient-initiated magnet-swipe storage of data during moments of obsessive thoughts; (2) lab-based, naturalistic provocation of OCD-related distress (naturalistic provocation task); and (3) lab-based, VR [virtual reality] provocation of OCD-related distress (VR provocation task).”[xxix] Such signals were used to identify when to deliver the therapeutic stimulation in order to counter the OCD symptoms. Thankfully, following the procedure and calibration the patient exhibited marked improvements in their OCD symptoms and recently shared her results publicly.[xxx] In both cases, there is a similar level of abductive justification for the efficacy of the delivered therapy. In the case study in which the patient was treated with adaptive deep brain stimulation, they at least had their neural activity tested in various settings to determine the optimum parameters for treatment to avoid them being based on guesswork. Additionally, the adaptive deep brain stimulation lead was already placed before the calibration trials were conducted, meaning that the patient had already taken on the bulk of the procedural risk before the efficacy could be determined. Such an efficacy test could have been replicated in the first patient’s cancer treatment, had it been biopsied and tested against the remaining immunotherapies in vitro. Yet, in the case of cancer with few options, one previous dose of a drug that appeared to work on the patient may justify further doses. However, as the Norwegian case presents, corroboration with known responses to a similar drug (from a clinical trial) could be helpful to validate the treatment strategy. (It should be noted that both patients were resigned to these last resort options regardless of the efficacy of treatment.) There are some elements of inductive logic seen with adaptive deep brain stimulation research in general. For example, abductively the focus could be that patient X’s stimulation parameters are different from patient Y’s and patient Z’s. In contrast, when grouped as subjects who obtained personalized stimulation, patients X, Y, and Z demonstrate an inductive aspect to this approach’s safety and/or efficacy. The OCD case holds plenty of abductive characteristics in line with precision medicine’s approach to treating cancer and as more individuals try the method, there will be additional data. With the gradual integration of AI into brain-computer interfaces in the name of efficacy, this reliance on abduction will continue, if not grow, over time. Moving forward, if a responsive deep brain stimulation treatment is novel and individualized (like the dose of nivolumab) and there is some other suggestion of efficacy (like clinical similarities to other patients in the literature), then it may justify insurance coverage for the investigative intervention, absent other unrelated reasons to deny it. III. Ethical Implications and Next Steps While AI’s use in oncology and neurology is not yet as prominent as its use in other fields (e.g., radiology), it appears to be on the horizon for both.[xxxi] AI can be found in both the functioning of the neurotechnologies as well as the implementation of precision medicine. The increasing use of AI may serve to further individualize both oncologic and neurological therapies. Given these implications and the handful of publications cited in this article, it is important to have a nuanced evaluation of how these treatments, which heavily rely on abductive justification, ought to be managed. The just use an abductive approach may be difficult as AI infused precision medicine is further pursued. At baseline, such technology relies on a level of advanced technology literacy among the general public and could exclude populations who lack access to basic technological infrastructure or know-how from participation.[xxxii] Even among nations with adequate infrastructure, as more patients seek out implantable neurotechnologies, which require robust healthcare resources, the market will favor patient populations that can afford this complex care.[xxxiii] If patients already have the means to pay for an initial dose/use of a precision medicine product out of pocket, should insurance providers be required to cover subsequent treatments?[xxxiv] That is, if a first dose of a cancer drug or a deep brain stimulator over its initial battery life is successful, patients may feel justified in having the costs of further treatments covered. The Norwegian patient’s experience implies there is a precedent for the idea that some public insurance companies ought to cover successful cancer therapies, however, insurance companies may not all see themselves as obligated to cover neurotechnologies that rely on personalized settings or that are based on precision/abductive research more than on clinical trials. CONCLUSION The fact that the cases outlined above rely on abductive style of reasoning implies that there may not be as strong a justification for coverage by insurance, as they are both experimental and individualized, when compared to the more traditional large clinical trials in which groups have the same or a standardized protocol (settings/doses). If a study is examining the efficacy of a treatment with a large cohort of patients or with different experimental groups/phases, insurance companies may conclude that the resulting symptom improvements are more likely to be coming from the devices themselves. A preference for inductive justification may take priority when ruling in favor of funding someone’s continued use of an implantable neurostimulator. There are further nuances to this discussion surrounding the classifications of these interventions as research versus clinical care that warrant future exploration, since such a distinction is more of a scale[xxxv] than binary and could have significant impacts on the “right-to-try” approach to experimental therapies in the United States.[xxxvi] Namely, given the inherent limitations of conducting large cohort trials for deep brain stimulation interventions on patients with neuropsychiatric disorders, surgically innovative frameworks that blend abductive and inductive methodologies, like with sham stimulation phases, have traditionally been used.[xxxvii] Similarly, for adaptive brain-computer interface systems, if there are no large clinical trials and instead only publications that demonstrate that something similar worked for someone else, then, in addition to the evidence that the first treatment/dose worked for the patient in question, the balance of reasoning would be valid and arguably justify insurance coverage. As precision approaches to neurotechnology become more common, frameworks for evaluating efficacy will be crucial both for insurance coverage and for clinical decision making. ACKNOWLEDGEMENT This article was originally written as an assignment for Dr. Francis Shen’s “Bioethics & AI” course at Harvard’s Center for Bioethics. I would like to thank Dr. Shen for his comments as well as my colleagues in the Lázaro-Muñoz Lab for their feedback. - [i] Jonathan Kimmelman and Ian Tannock, “The Paradox of Precision Medicine,” Nature Reviews. Clinical Oncology 15, no. 6 (June 2018): 341–42, https://doi.org/10.1038/s41571-018-0016-0. [ii] Henrik Vogt and Bjørn Hofmann, “How Precision Medicine Changes Medical Epistemology: A Formative Case from Norway,” Journal of Evaluation in Clinical Practice 28, no. 6 (December 2022): 1205–12, https://doi.org/10.1111/jep.13649. [iii] David Barrett and Ahtisham Younas, “Induction, Deduction and Abduction,” Evidence-Based Nursing 27, no. 1 (January 1, 2024): 6–7, https://doi.org/10.1136/ebnurs-2023-103873. [iv] Vogt and Hofmann, “How Precision Medicine Changes Medical Epistemology,” 1208. [v] Wireko Andrew Awuah et al., “Bridging Minds and Machines: The Recent Advances of Brain-Computer Interfaces in Neurological and Neurosurgical Applications,” World Neurosurgery, May 22, 2024, S1878-8750(24)00867-2, https://doi.org/10.1016/j.wneu.2024.05.104. [vi] Mark Riedl, “A Very Gentle Introduction to Large Language Models without the Hype,” Medium (blog), May 25, 2023, https://mark-riedl.medium.com/a-very-gentle-introduction-to-large-language-models-without-the-hype-5 f67941fa59e. [vii] David E. Burdette and Barbara E. Swartz, “Chapter 4 - Responsive Neurostimulation,” in Neurostimulation for Epilepsy, ed. Vikram R. Rao (Academic Press, 2023), 97–132, https://doi.org/10.1016/B978-0-323-91702-5.00002-5. 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