Name der Zeitschrift: Klio Jahrgang: 100 Heft: 2 Seiten: 575-580.

Background During the COVID-19 pandemic, virtual visiting technologies were rapidly integrated into the care offered by intensive care units (ICUs) in the UK and across the globe. Today, these technologies offer a necessary adjunct to in-person visits for those with ICU access limited by geography, work/caregiving commitments, or frailty. However, few empirical studies explore the ethical issues associated with virtual visiting. This study aimed to explore the anticipated or unanticipated ethical issues raised by using virtual visiting in the ICU, such (...) that healthcare professionals can be informed about how to carry out virtual visits ethically, safely and productively. Methods We used a descriptive exploratory qualitative research approach recruiting a convenience sample of newly-graduated junior doctors facilitating ICU virtual visits in a tertiary academic centre. Eight newly graduated junior doctors, seven female and one male, aged 23–27, participated in semi-structured interviews. We analysed transcripts using an inductive coding approach. Results Five overarching themes emerged. Two of the themes namely, ‘fulfilling a moral instinct to connect families’ and ‘promoting autonomy’, arose from participants’ descriptions of how virtual visits aligned with healthcare standards and practices they considered ethical. Three further themes, ‘preserving dignity and privacy’, ‘managing emotional distress’, and ‘providing equitable access’ to virtual visiting technologies, highlight how virtual visits might exacerbate ethical issues related to family communications. Conclusion Virtual visiting may potentially both ameliorate and exacerbate aspects of ethical healthcare delivery for ICU patients and family members. ICU team members should consider unique ethical considerations related to using virtual visiting. We recommend virtual communications skills training for staff and advocate for the use of easily accessible educational resources for families who wish to visit critically unwell patients remotely. (shrink)

In September 2009, the First Circuit Court of Appeals decided Blue Cross & Blue Shield v. AstraZeneca Pharmaceuticals LP, part of the class action suit known as In re Pharmaceutical Industry Average Wholesale Price Litigation. The First Circuit upheld a Massachusetts District Court finding that AstraZeneca violated Massachusetts’ consumer protection laws by manipulating the “average wholesale price” of its physician-administered injectable cancer drug Zoladex, leading to overpayment by the government, third-party payers, and consumers. This case, which highlights the persistent tension (...) between pharmaceutical pricing flexibility and consumer protection, has important implications for similar pending class actions.Between 1991 and 2003, Medicare, as well as many private insurance companies, pegged reimbursement for certain pharmaceutical products to a national “average wholesale price” for each drug. Although the amended 1991 Medicare Part B regulations3 that introduced the term “average wholesale price” failed to define it explicitly, there is some indication in the legislative history that AWP was intended to refer to the prices that physicians and pharmacists actually pay to the drug manufacturers. (shrink)

Philosophers have argued that stakes affect knowledge: a given amount of evidence may suffice for knowledge if the stakes are low, but not if the stakes are high. By contrast, empirical work on the influence of stakes on ordinary knowledge ascriptions has been divided along methodological lines: “evidence‐fixed” prompts rarely find stakes effects, while “evidence‐seeking” prompts consistently find them. We present a cross‐cultural study using both evidence‐fixed and evidence‐seeking prompts with a diverse sample of 17 populations in 11 countries, speaking (...) 14 languages. Our study is the first to use an evidence‐seeking prompt cross‐culturally, and includes several previously untested populations (including indigenous populations). Across cultures, we do not find evidence of a stakes effect with our evidence‐fixed prompt, but do with our evidence‐seeking prompt. We argue that the divergent results reveal a tension within folk epistemology: people's beliefs about when it is appropriate to ascribe knowledge differ significantly from their actual practice in ascribing knowledge. (shrink)

In Clark’s thoughtful analysis of the evolution of the two facets of pride, he suggests that the concurrent existence of hubristic and authentic pride in humans represents a “persistence problem,” wherein the vestigial trait (hubristic pride) continues to exist alongside the derived trait (authentic pride). In our view, evidence for the two facets does not pose a persistence problem; rather, hubristic and authentic pride both likely evolved as higher-order cognitive emotions that solve uniquely human—but distinct— evolutionary problems. Instead of (...) being conceptualized as serial homologues, with one the vestigial form of the other, we argue that hubristic and authentic pride are both derived homologues of a vestigial proto-pride emotion that existed in our shared ancestry with other primates. (shrink)

Herbert Clark argues that language use is more than the sum of a speaker speaking and a listener listening. It is the joint action that emerges when speakers and listeners, writers and readers perform their individual actions in coordination, as ensembles. In contrast to work within the cognitive sciences, which has seen language use as an individual process, and to work within the social sciences, which has seen it as a social process, the author argues strongly that language use (...) embodies both individual and social processes. (shrink)

The notion of folk‐psychology as a primitive speculative theory of the mental is called into question. There is cause to believe that folk‐psychology has more in common with a naive physics than with early speculative physical theorising. The distinction between these is elaborated. The conclusion drawn is that commonsense ascription of psychological content, though not a suitable finishing point for cognitive science, should still provide a more reliable source of data than some contemporary theorists are willing to admit.

Social robots serve people as tutors, caretakers, receptionists, companions, and other social agents. People know that the robots are mechanical artifacts, yet they interact with them as if they were actual agents. How is this possible? The proposal here is that people construe social robots not as social agentsper se, but asdepictionsof social agents. They interpret them much as they interpret ventriloquist dummies, hand puppets, virtual assistants, and other interactive depictions of people and animals. Depictions as a class consist of (...) three physical scenes with part-by-part mappings between them: (a) a base scene (the raw physical artifact), (b) the depiction proper (the artifact construed as a depiction), and (c) the scene depicted (the scene people are to imagine). With social robots, evidence shows people form the same three scenes plus mappings: They perceive the raw machinery of a robot, construe it as a depiction of a character, and, using the depiction as a guide, engage in the pretense that they are interacting with the character depicted. With social robots, people also recognize three classes of agents – the characters depicted, the intended recipients of the depictions (those who view or interact with the robots), and the authorities responsible for the robots (the designers, makers, and owners). Construing social robots as depictions, we argue, accounts for many phenomena not covered by alternative models. (shrink)

‘Predictive Processing’ is an emerging paradigm in cognitive neuroscience that depicts the human mind as an uncertainty management system that constructs probabilistic predictions of sensory s...

Drawing on work in psychophysics, psychometrics, and sensory neurophysiology, Clark analyzes the character and defends the integrity of psychophysical explanations of qualitative facts, arguing that the structure of such explanations is sound and potentially successful.

Clark Glymour, Richard Scheines, Peter Spirtes and Kevin Kelly. Discovering Causal Structure: Artifical Intelligence, Philosophy of Science and Statistical Modeling.

A Photcopy of Thinking Things Through, Princeton Univeresity Press, 1980.

We seem, or so it seems to some theorists, to experience a rich stream of highly detailed information concerning an extensive part of our current visual surroundings. But this appearance, it has been suggested, is in some way illusory. Our brains do not command richly detailed internal models of the current scene. Our seeings, it seems, are not all that they seem. This, then, is the Grand Illusion. We think we see much more than we actually do. In this paper (...) I shall (briefly) rehearse the empirical evidence for this rather startling claim, and then critically examine a variety of responses. One especially interesting response is a development of the so-called ‘skill theory’, according to which there is no illusion after all. Instead, so the theory goes, we establish the required visual contact with our world by an ongoing process of active exploration, in which the world acts as a kind of reliable, interrogable, external memory (Noe, Pessoa and. (shrink)

This paper considers the extent to which market institutions respond to the needs and morally significant interests of future generations. Such an analysis of the intertemporal effects of markets provides important ground for evaluation of normative social theories, and represents a crucial step toward the development of an adequate account of intergenerational justice. After presenting a prima facie case that markets cannot provide appropriate protections for future needs and interests, I evaluate and reject two of the most promising arguments that (...) purport to rebut this case. None of these arguments is adequate to show that markets will protect the interests of future generations. Given important grounds for pessimism about non-market solutions, this leaves little room for hope that we can successfully preserve productive resources that future generations will need to satisfy their basic needs. However, I tentatively suggest where this hope may reside. (shrink)

This book offers a systematic account of the reduction of psychological models of behavior to underlying neural mechanisms. "Clark has approached an extremely difficult and important issue in a systematic masnner and has done much to clarify concepts that are all too often mismanaged and confused in the psychological literature." --American Scientist.

The theory of boundary organizations was developed to address an important group of institutions in American society neglected by scholarship in science studies and political science. The long-term stability of scientific and political institutions in the United States has enabled a new class of institutions to grow and thrive as mediators between the two. As originally developed, this structural feature of these new institutions—that is, their location on the boundary between science and politics—dominated theoretical frame-works for explaining their behavior. Applying (...) the theory of boundary organizations to international society requires a refocusing of some of the theory’s central features, however. In this article, I introduce a new framework—hybrid management—to explain the activities of boundary organizations in the more complex, contingent, and contested settings of global politics. I develop the framework of hybrid management using the specific example of the U.N. Framework Convention on Climate Change’s Subsidiary Body for Scientific and Technological Advice. (shrink)

I argue that the best explanation of the multiplicity of available frameworks for treating any given philosophical topic is that philosophy currently (though not insuperably) lacks fixed standards; I then go on to identify three barriers to philosophical progress associated with our present epistemic situation. First is that the lack of fixed standards encourages what I call “intra‐disciplinary siloing,” and associated dialectical and argumentative failings; second is that the lack of fixed standards makes room for sociological factors (including elite influence (...) and disciplinary inertia) to be determinative of which philosophical frameworks are embraced; third is that the lack of fixed standards encourages (implicit and/or explicit) bias. I close by offering some suggestions about how to move beyond these barriers, even in the absence of fixed standards. (shrink)

Connectionism and classicism, it appears, have at least this much in common: both place some notion of internal representation at the heart of a scientific study of mind. In recent years, however, a much more radical view has gained increasing popularily. This view calls into question the commitment to internal representation itself. more strikingly still, this new wave of anti-representationalism is rooted not in 'armchair' theorizing but in practical attempts to model and understand intelligent, adaptive behaviour. In this paper we (...) first present, and then critically assess, a variety of recent anti-representationalist treatments. We suggest that so far, at least, the sceptical rhetoric outpaces both evidence and argument. Some probable causes of this premature scepticism are isolated. nonetheless, the anti-representationalist challenge is shown to be both important and progressive insofar as it forces us to see beyond the bare representational/ non-represenational dichotomy and to recognize instead a rich continuum of degrees and types of represenatationality. (shrink)

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This paper contrasts three different schemes of reference relevant to understanding systems of perceptual representation: a location-based system dubbed "feature-placing", a system of "visual indices" referring to things called "proto-objects", and the full sortal-based individuation allowed by a natural language. The first three sections summarize some of the key arguments (in Clark, 2000) to the effect that the early, parallel, and pre-attentive registration of sensory features itself constitutes a simple system of nonconceptual mental representation. In particular, feature integration--perceiving something (...) as being both F and G, where F and G are sensible properties registered in distinct parallel streams--requires a referential apparatus. Section V. reviews some grounds for thinking that at these earliest levels this apparatus is location-based: that it has a direct and nonconceptual means of picking out places. Feature-placing is contrasted with a somewhat more sophisticated system that can identify and track four or five "perceptual objects" or "proto-objects", independently of their location, for as long as they remain perceptible. Such a system is found in Zenon Pylyshyn's fascinating work on "visual indices", in Dana Ballard's notion of deictic codes, and in Kahneman, Treisman, and Wolfe's accounts of systems of evanescent representations they call "object files". Perceptual representation is a layered affair, and I argue that it probably includes both feature-placing and proto-objects. Finally, both nonconceptual systems are contrasted with the full-blooded individuation allowed in a natural language. (shrink)

Of the many proposals for inferring genetic regulatory structure from microarray measurements of mRNA transcript hybridization, several aim to estimate regulatory structure from the associations of gene expression levels measured in repeated samples. The repeated samples may be from a single experimental condition, or from several distinct experimental conditions; they may be “equilibrium” measurements or time series; the associations may be estimated by correlation coefficients or by conditional frequencies (for discretized measurements) or by some other statistic. This paper describes two (...) elementary statistical difficulties for all such procedures, no matter whether based on Bayesian updating, conditional independence testing, or other machine learning procedures such as simulated annealing or neural net pruning. One difficulty obtains if large numbers of cells are aggregated in a measurement of expression levels from a common population of cells; the other obtains if small numbers of cells are aggregated or if samples are separately aggregated over different populations of cells. (shrink)

The conflict between drug and conventional rewards leads to a paradox: Sanctions against drug use decrease access to conventional rewards and push drug users toward drug abuse, whereas increased access to the rewards of family, friends, and work may help reduce drug abuse. Lack of control is not specific to drug addiction and is unlikely to yield to a shift in bookkeeping.

In everyday joint activities, people coordinate with each other by means not only of linguistic signals, but also of material signals – signals in which they indicate things by deploying material objects, locations, or actions around them. Material signals fall into two main classes: directing-to and placing-for. In directing-to, people request addressees to direct their attention to objects, events, or themselves. In placing-for, people place objects, actions, or themselves in special sites for addressees to interpret. Both classes have many subtypes. (...) Features of material signals were examined in pairs of people who were videotaped as they assembled TV stands, built Lego models, planned furnishings for a house, played piano duets, or bought coffee at Starbucks. In these activities, the pointing and placements were often sustained, creating three phases of signals – initiation, maintenance, and termination – each with its own interpretation. (shrink)

Hume argued that experience could not justify commonly held beliefs in singular causal effcacy, according to which individual or singular causes produce their effects or make their effects happen. Hume's discussion has been influential, as motivating the view that Causal reductionism (denying that causal efficacy is an irreducible feature of natural reality) requires Causal generalism (according to which causal relations are metaphysically constituted by patterns of events). Here I argue that causal reductionists---indeed, Hume himself---have previously unappreciated resources for making sense (...) of Causal singularism, associated with a relation that has been curiously underexploited in the causation debates: resemblance. The core idea I explore here is that causation may be metaphysically and epistemologically indicated by the coming-to-be of a resemblance. Comings-to-be of resemblances are epistemically available in the singular instance, even by Hume's strict lights, and, I argue, can justify (albeit fallibly) belief in the holding of singular causal relations; hence Hume's general argument for generalism fails. More to the contemporary metaphysical point, comings-to-be of resemblances provide valuable resources for existing singularist accounts: while neither changes (Ducasse) nor transfers of physical quantities (Fair, Dowe, Salmon) provide a suffciently fine-grained basis for the individuation of causes, either changes or transfers, in combination with comings-to-be of resemblances, can do so. (shrink)

This article advances recent scholarship on energy security by arguing that the concept is best understood as a sociotechnical imaginary, a collective vision for a “good society” realized through technoscientific-oriented policies. Focusing on the 1952 Resources for Freedom report, the authors trace the genealogy of energy security, elucidating how it establishes a morality of efficiency that orients policy action under the guise of security toward the liberalizing of markets in resource states and a robust program of energy research and development (...) in the United States. This evidence challenges the pervasive historical anchoring of the concept in the 1970s and illustrates the importance of the genealogical approach for the emerging literature on energy and sociotechnical imaginaries. Exploring the genealogy of energy security also unpacks key social, political, and economic undercurrents that disrupt the seeming universality of the language of energy, leading the authors to question whether energy security discourse is appropriate for guiding policy action during ongoing global energy transitions. (shrink)

Clark highlights a neglected issue in research on language use: the process by which speakers and addressees anchor utterances with respect to individual entities in their common ground. In his review, he identifies the challenges linked to investigations of anchoring, but also displays the pitfalls of evading it.

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No detailed description available for "Semantics and Comprehension".

Regulatory agencies aim to protect the public by moderating risks associated with innovation, but a good regulatory regime should also promote justified public trust. After introducing the USDA 2020 SECURE Rule for regulation of biotech innovation as a case study, this essay develops a theory of justified public trust in regulation. On the theory advanced here, to be trustworthy, a regulatory regime must (1) fairly and effectively manage risk, must be (2) “science based” in the relevant sense, and must in (...) addition be (3) truthful, (4) transparent, and (5) responsive to public input. Evaluated with these norms, the USDA SECURE Rule is shown to be deeply flawed, since it fails appropriately to manage risk, and similarly fails to satisfy other normative requirements for justified trust. The argument identifies ways in which the SECURE Rule itself might be improved, but more broadly provides a normative framework for the evaluation of trustworthy regulatory policy-making. (shrink)

Timely and much-needed theory of humanity's relation to the planet.

Mind, it has recently been argued1, is a thoroughly temporal phenomenon: so temporal, indeed, as to defy description and analysis using the traditional computational tools of cognitive scientific understanding. The proper explanatory tools, so the suggestion goes, are instead the geometric constructs and differential equations of Dynamical Systems Theory. I consider various aspects of the putative temporal challenge to computational understanding, and show that the root problem turns on the presence of a certain kind of causal web: a web that (...) involves multiple components (both inner and outer) linked by chains of continuous and reciprocal causal influence. There is, however, no compelling route from such facts about causal and temporal complexity to the radical anti- computationalist conclusion. This is because, interactive complexities notwithstanding, the computational approach provides a kind of explanatory understanding that cannot (I suggest) be recreated using the alternative resources of pure Dynamical Systems Theory. In particular, it provides a means of mapping information flow onto causal structure -- a mapping that is crucial to understanding the distinctive kinds of flexibility and control characteristic of truly mindful engagements with the world. Where we confront especially complex interactive causal webs, however, it does indeed become harder to isolate the syntactic vehicles required by the computational approach. Dynamical Systems Theory, I conclude, may play a vital role in recovering such vehicles from the burgeoning mass of real-time interactive complexity. (shrink)

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