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

Review of: A History of Sociological Research Methods in America, 1920-1960, by Jennifer Platt. -/- One might expect a history of research methods in sociology during the 40 years this book examines to deal with such questions as the conceptual preconditions for the statistical techniques employed during the period, the changes in statistical practice, the failure of the effort to measure attitudes in a dramatically more precise way, the failure of the many hopes and expectations of methodologists, for (...) the creation of a true science, and so forth. Some of these issues do peep out from the text now and then. But Platt's central concern is quite different. Despite the title, the book is not concerned with the development of techniques. It is instead a highly polemical attack on various previous writers and certain conventional historical opinions about this period. (shrink)

Ideal epistemologists investigate the nature of pure epistemic rationality, abstracting away from human cognitive limitations. Non-ideal epistemologists investigate epistemic norms that are satisfiable by most humans, most of the time. Ideal epistemology faces a number of challenges, aimed at both its substantive commitments and its philosophical worth. This paper explains the relation between ideal and non-ideal epistemology, with the aim of justifying ideal epistemology. Its approach is meta-epistemological, focusing on the meaning and purpose of epistemic evaluations. I provide an account (...) on which the fundamental difference between ideal and non-ideal epistemic evaluations is that only the non-ideal epistemic ‘ought’ implies any substantive ‘can’. I argue that only ideal epistemic evaluations are ‘normatively robust’: they are neither conventional nor seriously context-sensitive. Non-ideal epistemic evaluations are normatively non-robust, exhibiting both conventionality and serious context-sensitivity from an interesting variety of distinct sources. For this reason, non-ideal epistemic evaluations won’t characterize the fundamental nature of epistemic rationality. Non-ideal epistemic rationality depends, not merely on what’s epistemically valuable, but also on modally contingent epistemic conventions and contextually contingent constraints on epistemic options. If we want a normatively robust theory of epistemic rationality, ideal epistemology is the only game in town. (shrink)

Harman’s lottery paradox, generalized by Vogel to a number of other cases, involves a curious pattern of intuitive knowledge ascriptions: certain propositions seem easier to know than various higher-probability propositions that are recognized to follow from them. For example, it seems easier to judge that someone knows his car is now on Avenue A, where he parked it an hour ago, than to judge that he knows that it is not the case that his car has been stolen and driven (...) away in the last hour. Contextualists have taken this pattern of intuitions as evidence that ‘knows’ does not always denote the same relationship; subject-sensitive invariantists have taken this pattern of intuitions as evidence that non-traditional factors such as practical interests figure in knowledge; still others have argued that the Harman Vogel pattern gives us a reason to abandon the principle that knowledge is closed under known entailment. This paper argues that there is a psychological explanation of the strange pattern of intuitions, grounded in the manner in which we shift between an automatic or heuristic mode of judgment and a controlled or systematic mode. Understanding the psychology behind the pattern of intuitions enables us to see that the pattern gives us no reason to abandon traditional intellectualist invariantism. The psychological account of the paradox also yields new resources for clarifying and defending the single premise closure principle for knowledge ascriptions. (shrink)

Recent scholarship (Goodwin & Darley, 2008) on the meta-ethical debate between objectivism and relativism has found people to be mixed: they are objectivists about some issues, but relativists about others. The studies discussed here sought to explore this further. Study 1 explored whether giving people the ability to identify moral issues for themselves would reveal them to be more globally objectivist. Study 2 explored people's meta-ethical commitments more deeply, asking them to provide verbal explanations for their judgments. This revealed that (...) while people think they are relativists, this may not always be the case. The explanations people gave were sometimes rated by outside (blind) coders as being objective, even when given a relativist response. Nonetheless, people remained meta-ethical pluralists. Why this might be is discussed. (shrink)

Prediction‐based processes appear to play an important role in language. Few studies, however, have sought to test the relationship within individuals between prediction learning and natural language processing. This paper builds upon existing statistical learning work using a novel paradigm for studying the on‐line learning of predictive dependencies. Within this paradigm, a new “prediction task” is introduced that provides a sensitive index of individual differences for developing probabilistic sequential expectations. Across three interrelated experiments, the prediction task and results thereof are (...) used to bridge knowledge of the empirical relation between statistical learning and language within the context of nonadjacency processing. We first chart the trajectory for learning nonadjacencies, documenting individual differences in prediction learning. Subsequent simple recurrent network simulations then closely capture human performance patterns in the new paradigm. Finally, individual differences in prediction performances are shown to strongly correlate with participants’ sentence processing of complex, long‐distance dependencies in natural language. (shrink)

In Moody Minds Distempered philosopher Jennifer Radden assembles several decades of her research on melancholy and depression. The chapters are ordered into three categories: those about intellectual and medical history of melancholy and depression; those that emphasize aspects of the moral, psychological and medical features of these concepts; and finally, those that explore the sad and apprehensive mood states long associated with melancholy and depressive subjectivity. A newly written introduction maps the conceptual landscape, and draws out the analytic and (...) thematic interconnections between the chapters. Radden emphasizes and develops several new themes: the implications, theoretical phenomenological and moral, of recognizing melancholy and depressive states as mood states; questions of method, as they affect how we understand and characterize claims about melancholy and depression; and the persistence and force of cultural tropes linking such states to brilliance, creativity, and sagacity. Insights from literature and the history of medicine, psychology, and psychiatry are woven together with those from the more recent disciplines of feminist theory and cultural studies. This is interdisciplinary writing at its best-part analytic philosophy, and part history of ideas. (shrink)

The phenomenon of pain presents problems and puzzles for philosophers who want to understand its nature. Though pain might seem simple, there has been disagreement since Aristotle about whether pain is an emotion, sensation, perception, or disturbed state of the body. Despite advances in psychology, neuroscience, and medicine, pain is still poorly understood and multiple theories of pain abound. The Routledge Handbook of Philosophy of Pain is an outstanding reference source to the key topics, problems and debates in this exciting (...) and interdisciplinary subject and is the first collection of its kind. Comprising over thirty chapters by a team of international contributors the Handbook is divided into nine clear parts: Modelling pain in philosophy Modelling pain in neuroscience Modelling pain in psychology Pain in philosophy of mind Pain in epistemology Pain in philosophy of religion Pain in ethics Pain in medicine Pain in law. As well as fundamental topics in the philosophy of pain such as the nature, role, and value of pain, many other important topics are covered including the neurological pathways involved in pain processing, biopsychosocial and cognitive behavioural models of pain; chronic pain; pain and non-human animals; pain and knowledge; controlled substances for pain; pain and placebo effects; and pain and physician assisted suicide. The Routledge Handbook of Philosophy of Pain is essential reading for students and researchers in philosophy of mind, philosophy of psychology and ethics. It will also be very useful to researchers of pain from any field, especially those in psychology, medicine, and health studies. (shrink)

Stories are an important indicator of our vision of the future. In the case of artificial intelligence (AI), dominant stories are polarized between notions of threat and myopic solutionism. The central storytellers—big tech, popular media, and authors of science fiction—represent particular demographics and motivations. Many stories, and storytellers, are missing. This paper details the accounts of missing AI narratives by leading scholars from a range of disciplines interested in AI Futures. Participants focused on the gaps between dominant narratives and the (...) untold stories of the capabilities, issues, and everyday realities of the technology. One participant proposed a “story crisis” in which these narratives compete to shape the public discourse on AI. Our findings indicate that dominant narratives distract and mislead public understandings and conceptions of AI. This suggests a need to pay closer attention to missing AI narratives. It is not simply about telling new stories, it is about listening to existing stories and asking what is wanted from AI. We call for realistic, nuanced, and inclusive stories, working with and for diverse voices, which consider (1) story-teller; (2) genre, and (3) communicative purpose. Such stories can then inspire the next generation of thinkers, technologists, and storytellers. (shrink)

There is growing interest in the processes by which entrepreneurial opportunities are cocreated between entrepreneurs and their stakeholders. The longitudinal case study of de novo firm Wakefield Seafoods seeks to understand the underlying dynamics of phenomena that play out over time as stakeholders emerge and their contributions become essential to the opportunity formation process. The king crab data show that under conditions of uncertainty, characterized by incomplete or missing knowledge, entrepreneurial processes of experimentation, failure, and learning were effective in forming (...) and exploiting an opportunity. Moreover, contrary to existing literature that either emphasizes heroic entrepreneurs or downplays their value, this article shows that both the vision of the entrepreneur and the stakeholder contributions are critical. This detailed examination of process data shows that the cumulative actions made by entrepreneurs in concert with their stakeholders formed an opportunity that coalesced into a new market. (shrink)

Immanuel Kant's moral philosophy is one of the most distinctive achievements of the European Enlightenment. At its heart lies what Kant called the "strange thing": the free rational human will. This introduction explores the basis of Kant's anti-naturalis, secular, moral vision of the human good. Moving from a sketch of the Kantian will, with all its component parts and attributes, to Kant's canonical arguments for his categorical imperative, it shows why Kant thought his moral law the best summary expression of (...) both his own philosophical work on morality and his readers' deepest shared convictions about the good. Kant's central tenets, his key arguments, and core values are presented in an accessible and engaging way, making this book ideal for anyone eager to explore the fundamentals of Kant's moral philosophy. (shrink)

In this paper, I make the case for the view that there are many different kinds of dispositions, a view I call dispositional pluralism. The reason I think that this case needs to be made is to temper the tendency to make sweeping generalization about the nature of dispositions that go beyond conceptual truths. Examples of such generalizations include claims that all dispositions are intrinsic, essential, fundamental, or natural.! In order to counter this tendency, I will start by noting the (...) extent to which it is at odds with the semantics of dispositions, according to which there are many kinds of disposition ascriptions. From there, I will try to support a metaphysical claim that there are different kinds of dispositions. To bridge the gap between semantics and metaphysics, I appeal to epistemology. I'll consider the question "when do we have good reason to believe that a disposition ascription is true?" If our disposition ascriptions are true, then we are right about what kinds of dispositions things have, and what kinds of dispositions there are. I claim that our evidence for different kinds of dispositions is on a par; we have reason to believe that various kinds of dispositions are instantiated. (shrink)

The paper aims to develop a theoretical reflection on existing knowledge in public policy and its implementation in the nineties. This is a documental research design of bibliographical nature. The results reveal that the body of knowledge in public policy has been under the domain of rational choice theory and the assumptions of the neoclassical school. I conclude that, in the context of an alternative model to the neoliberal one, one need a different theoretical tool for alternative public policy that (...) consider social rationality moving away from a deterministic and technical policy. Este trabajo tiene como propósito desarrollar una reflexión teórica al conocimiento existente en materia de política pública y de su implementación en la década de los noventa. Esta es una investigación documental con un tipo de diseño de carácter bibliográfico. Los resultados revelan que el cuerpo de conocimientos en materia de política pública, ha estado bajo el dominio de la Teoría de la Elección Racional y de los supuestos de la Escuela Neoclásica. Se concluye que, en el marco de un modelo alternativo al neoliberal, se necesita un instrumental teórico diferente para una política pública alternativa. Esto pasa por considerar una racionalidad social que se aleje de una concepción determinista y técnica de la política. (shrink)

Feminist metaphysics is simultaneously feminist theorizing and metaphysics. Part of feminist metaphysics concerns social ontology and considers such questions as, What is the nature of social kinds, such as genders? Feminist metaphysicians also consider whether gendered perspectives influence metaphysical theorizing; for example, have approaches to the nature of the self or free will been conducted from a masculinist perspective, and would a feminist perspective yield different theories? Some feminist metaphysicians develop metaphysical theories with the aim of furthering certain social goals, (...) such as gender equality. Despite these and other intriguing research projects, feminist metaphysics faces challenges from two flanks: one might argue that "feminist metaphysics" is not metaphysics, or one might argue that it is not feminist. Recently, Elizabeth Barnes has made the case that, since contemporary accounts of the nature of metaphysics focus primarily on the fundamental, they have the problematic implication that feminist metaphysics is not, properly speaking, metaphysics. However, less emphasis has been paid, of late, to the idea that major strands of feminist thought also problematize feminist metaphysics. I will briefly assess the metaphysician's case against feminist metaphysics in Section 2 of this chapter. Then, in Section 3, I will examine in more detail possible feminist concerns over metaphysics. In Section 4, I sketch a different conception of metaphysics that avoids both mainstream and feminist challenges to feminist metaphysics. (shrink)

First published in 1987. Routledge is an imprint of Taylor & Francis, an informa company.

The gestational surrogate – and her economic and educational vulnerability in particular – is the focus of many of the most persistent worries about paid surrogacy. Those who employ her, and those who broker and organize her services, usually have an advantage over her in resources and information. That asymmetry exposes her to the possibility of exploitation and abuse. Accordingly, some argue for banning paid surrogacy. Others defend legal permission on grounds of surrogate autonomy, but often retain concerns about the (...) surrogate. In response to the dilemma of a ban versus bald permission, we propose a 'soft law' approach: states should require several hours of education of surrogates – education aimed at informing and enhancing surrogate autonomy. (shrink)

Hearers of the Sermon on the Mount are called to become children of their heavenly father by loving as God loves. Surprisingly, though, God's love is depicted here as impersonal and indiscriminate, as similar to or even simply as a force of nature, even if a life-giving force: God `makes his sun to rise on the evil and the good, and sends rain on the just and the unjust' (Matthew 5:45). Anders Nygren used this verse as core support for his (...) dubious characterization of agape as `indifferent to value'. How should we hear it today? (shrink)

As virtuous leadership appears to be under severe pressure in all areas of life, it is the aim of this article to determine whether this biblical axiom holds suitable and valuable guidelines to counter contemporary leadership traps and assist leaders not to succumb to ambitious leadership cravings. The article determines whether the biblical axiom, the first shall be last and the last shall be first, holds the capacity to invert the corrupt pressure-cooker drives for both religious and secular leadership ambitions. (...) It examines the biblical and ethical wisdom of this teaching as well as the authoritative relevance it holds for leadership formation and practice. It determines whether a biblically infused value system still contains the moral capacity that contributes to the observance of resonant and ethical leadership capable of reversing pervasive situations of corrupt and incompetent leadership. In addition, the article contemplates the Christian weight of this biblical axiom to place those who are last, first in the service of leadership. In the same vein, it examines some of the ‘leadership traps’ experienced by persons who occupy lay, clerical, professional and secular positions. It endeavours to offer reflective biblical, moral and spiritual solutions that arise from the spirituality offered by Matthew 20:16 to current leadership demises.Contribution: The theme of the Leadership conference where this article was presented was the biblical verse: ‘The first shall be last and the last shall be first’. The article focuses directly on the implications of the biblical axiom and relate, as well as, translate it to leadership difficulties as experienced today. (shrink)

Advances in our understanding of appraisal processes and emotion regulation have been two of the most important contributions of research on cognition and emotion in recent decades. Interestingly, however, progress in these two areas has been less mutually informative than one might expect or desire. To help remedy this situation, we provide an integration of appraisal theory and the process model of emotion regulation by describing parallel, interacting and iterative systems for emotion generation and emotion regulation. Outputs of the emotion (...) generation system are perceived by the emotion regulation system, and emotion regulation strategies then modulate emotion by intervening at specific stages of the emotion generation system, ultimately changing appraisal dimensions. We hope that our unified perspective will encourage and guide future research at the interface of cognition and emotion. (shrink)

We study the relationship between algebraic structures and their inverse semigroups of partial automorphisms. We consider a variety of classes of natural structures including equivalence structures, orderings, Boolean algebras, and relatively complemented distributive lattices. For certain subsemigroups of these inverse semigroups, isomorphism of the subsemigroups yields isomorphism of the underlying structures. We also prove that for some classes of computable structures, we can reconstruct a computable structure, up to computable isomorphism, from the isomorphism type of its inverse semigroup of computable (...) partial automorphisms. (shrink)

Medical interpreters are indispensable in healthcare, breaking down language barriers to restore autonomy to patients with Limited English Proficiency (LEP). By facilitating clear communication, they enable these patients to understand and make informed choices about their treatment options. However, their role extends beyond translation; medical interpreters also advocate for LEP patients within a healthcare system that can often be unjust. This advocacy can expose interpreters to the very inequities and challenges they strive to overcome on behalf of LEP patients, adversely (...) affecting their own health and well-being. The narratives explored here shed light on these experiences, highlighting the need for systemic changes. By understanding these stories, we can better advocate for reforms that support and value medical interpreters, ultimately improving the health and well-being of both interpreters and the communities they serve. (shrink)